Mycophenolate mofetil vs azathioprine in a large population of elderly renal transplant patients

Herwig Ulf Meier-Kriesche, Jonathan A. Morris, Alice H. Chu, Bettina J. Steffen, Vincent P. Gotz, Robert D. Gordon, Bruce Kaplan

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background. Mycophenolate mofetil (MMF) has been shown to decrease acute rejection episodes after kidney transplantation, and has been associated with better graft and patient survival vs azathioprine (AZA). Previous studies reported a higher risk of death due to infection in elderly recipients treated with MMF-based immunosuppression. Methods. We analysed 5069 elderly (> 65 years of age) primary renal allograft recipients treated with either MMF or AZA reported to the Scientific Registry of Transplant Recipients between 1988 and 2000, and compared rates of acute rejection, late acute rejection, graft survival, death-censored graft survival, patient survival and death with a functioning graft. Results. In Cox proportional hazard models, MMF was associated with lower rates of late acute rejection with 12 (RR = 0.72, P = 0.11) and 24 months (RR = 0.50, P = 0.028) of continuous therapy. In univariate analysis (Kaplan-Meier), MMF was associated with improved patient (P = 0.0003) and graft (P <0.0001) survival vs AZA, and trends toward improved patient and graft survival in multivariate analyses. Conclusions. These findings demonstrate the efficacy of MMF-based immunosuppression in elderly transplant recipients and do not suggest an increased risk of death compared to treatment with AZA.

Original languageEnglish (US)
Pages (from-to)2864-2869
Number of pages6
JournalNephrology Dialysis Transplantation
Volume19
Issue number11
DOIs
StatePublished - Nov 2004
Externally publishedYes

Fingerprint

Mycophenolic Acid
Azathioprine
Graft Survival
Transplants
Kidney
Population
Immunosuppression
Survival
Kaplan-Meier Estimate
Proportional Hazards Models
Kidney Transplantation
Allografts
Registries
Multivariate Analysis
Therapeutics
Infection

Keywords

  • Azathioprine
  • Elderly patients
  • Immunosuppression
  • Mycophenolate mofetil
  • Renal transplantation

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

Meier-Kriesche, H. U., Morris, J. A., Chu, A. H., Steffen, B. J., Gotz, V. P., Gordon, R. D., & Kaplan, B. (2004). Mycophenolate mofetil vs azathioprine in a large population of elderly renal transplant patients. Nephrology Dialysis Transplantation, 19(11), 2864-2869. https://doi.org/10.1093/ndt/gfh445

Mycophenolate mofetil vs azathioprine in a large population of elderly renal transplant patients. / Meier-Kriesche, Herwig Ulf; Morris, Jonathan A.; Chu, Alice H.; Steffen, Bettina J.; Gotz, Vincent P.; Gordon, Robert D.; Kaplan, Bruce.

In: Nephrology Dialysis Transplantation, Vol. 19, No. 11, 11.2004, p. 2864-2869.

Research output: Contribution to journalArticle

Meier-Kriesche, HU, Morris, JA, Chu, AH, Steffen, BJ, Gotz, VP, Gordon, RD & Kaplan, B 2004, 'Mycophenolate mofetil vs azathioprine in a large population of elderly renal transplant patients', Nephrology Dialysis Transplantation, vol. 19, no. 11, pp. 2864-2869. https://doi.org/10.1093/ndt/gfh445
Meier-Kriesche, Herwig Ulf ; Morris, Jonathan A. ; Chu, Alice H. ; Steffen, Bettina J. ; Gotz, Vincent P. ; Gordon, Robert D. ; Kaplan, Bruce. / Mycophenolate mofetil vs azathioprine in a large population of elderly renal transplant patients. In: Nephrology Dialysis Transplantation. 2004 ; Vol. 19, No. 11. pp. 2864-2869.
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