Should Mycophenolate Mofetil (MMF) Replace Azathioprine (AZA) in Preventing the Allograft Rejection after Kidney Transplantations?

Kidney transplantation is the preferred treatment when chronic kidney disease (CKD) reaches the end stage. Despite the fact that renal transplantation lowers the mortality and improves life quality, allograft rejection is the major threat for graft survival. Therefore, the post renal transplantation management regimen is required following the transplant surgery, involving the prescriptions of immunosuppressive drugs, Mycophenolate mofetil (MMF) and Azathioprine (AZA), to inhibit the rejection of the immune system and increase the survival rate and life expectancy among patients. MMF alleviates the acute rejection following the renal transplantation more effectively (by 30- 50% compared with AZA) and with less severe adverse effects (MMF is less hepatotoxic and mutagenic) and associates with lower graft loss compared with AZA. However, the price of MMF is more than 15 times the price of AZA.

關鍵字

Mycophenolate Mofetil ； Azathioprine ； Immunosuppressant ； Kidney Transplantation

參考文獻

Bhatti, A., & Usman, M. (2015). Chronic Renal Transplant Rejection and Possible Anti- Proliferative Drug Targets. Cureus. doi: 10.7759/ cureus.376.

Wagner, M., Earley, A., Webster, A., Schmid, C., Balk, E., & Uhlig, K. (2015). Mycophenolic acid versus azathioprine as primary immunosuppression for kidney transplant recipients. Cochrane Database Of Systematic Reviews. doi: 10.1002/14651858.cd007746.pub2.

Wagner, M., Balk, E., Webster, A., Raman, G., Trikalinos, T., Schmid, C., & Uhlig, K. (2009). Mycophenolic acid versus azathioprine as primary immunosuppression for kidney transplant recipients. Cochrane Database Of Systematic Reviews. doi: 10.1002/14651858.cd007746.

Meier-Kriesche, H. (2004). Mycophenolate mofetil vs azathioprine in a large population of elderly renal transplant patients. Nephrology Dialysis Transplantation, 19(11), 2864-2869. doi: 10.1093/ndt/gfh445.

Kher, V., Singhal, M., Bansal, S., Pokhariyal, S., Saxena, V., & Gupta, P. et al. (2011). Comparison of azathioprine with mycophenolate mofetil in a living donor kidney transplant programme. Indian Journal Of Nephrology, 21(4), 258. doi: 10.4103/0971-4065.85483.

延伸閱讀

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國際替代計量

Should Mycophenolate Mofetil (MMF) Replace Azathioprine (AZA) in Preventing the Allograft Rejection after Kidney Transplantations?

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