Mycophenolate mofetil: long-term outcomes in solid organ transplantation

Abstract

Mycophenolate mofetil (MMF), the morpholinoethyl ester of mycophenolic acid (MPA), an inosine monophosphate dehydrogenase (IMPDH) inhibitor, has become the most widely used antiproliferative immunosuppressant in solid organ transplantation. Herein the pharmacology of MMF and prospective clinical studies with MMF is reviewed. Long-term outcomes data from the national transplant registries relevant to MMF in kidney and liver transplantation are summarized. The expanding use of MMF in high-risk renal transplant recipients is discussed. The use of MMF in nontransplant indications such as autoimmune disease is also briefly reviewed. In coming years, previously demonstrated beneficial effects of MMF in transplantation will need re-evaluation in the context of the growing use of MMF with tacrolimus or sirolimus and newer agents such as the malononitrilamides and sirolimus.

Keywords::

• mycophenolate mofetil
• mycophenolic acid
• outcomes
• pharmacokinetics
• solid organ transplantation