• Jorge Andrade-Sierra, Hernesto Hernández-Reyes, Enrique Rojas-Campos, Ernesto Germán Cardona-Muñoz, José Ignacio Cerrillos-Gutiérrez, Eduardo González-Espinoza, Luis Alberto Evangelista-Carrillo, Miguel Medina-Pérez, Basilio Jalomo-Martínez, Alejandra Guillermina Miranda-Díaz, Víctor Manuel Martínez-Mejía, Benjamin Gómez-Navarro, Antonio de Jesús Andrade-Ortega, Juan José Nieves-Hernández, and Claudia Alejandra Mendoza-Cerpa.
• Department of Physiology, University Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico.
• Medicine (Baltimore). 2023 Nov 17; 102 (46): e35841e35841.

AbstractEvidence supporting a starting dose of 2 g/day of mycophenolate mofetil (MMF) in combination with tacrolimus (TAC) for renal transplantation (RT) is still limited, but maintaining a dose of <2 g could result in worse clinical outcomes in terms of acute rejection (AR). This study aimed to determine the association between AR and infectious and noninfectious complications after RT with a dose of 1.5 g vs 2 g of MMF. A prospective cohort study was performed with a 12-month follow-up of recipients of RT from living donors with low (1.5 g/day) or standard (2 g/day) doses of MMF. The association between adverse effects and complications and doses of MMF was examined using Cox proportional hazard models, and survival free of AR, infectious diseases, and noninfectious complications was evaluated using the Kaplan-Meier test. At the end of the follow-up, the incidence of infectious diseases was 52% versus 50% (P = .71) and AR was 5% versus 5% (P = .86), respectively. The survival rate free of gastrointestinal (GI) complications requiring medical attention was higher in the low-dose group than in the standard-dose dose (88% vs 45%, respectively; P < .001). The use of 1.5 g/day of MMF confers a reduction in GI complications without an increase in infectious diseases or the risk of AR.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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