The Influence of Mycophenolate(MMF) and Azathioprine(AZA) in the Same Cadaveric Renal Transplantation

Do, Jung Ho; Huh, Wooseong; Kim, Jung Ah; Lee, Hyo Rak; Choi, Sung Chul; Han, Hyeok Jun; Kim, Dae Joong; Kim, Yoon Goo; Oh, Ha Young; Lee, Kwang Woong; Kim, Sung Joo; Joh, Jae Won

Abstract

OBJECTIVE
In order to evaluate how immunosuppressive agents such as MMF and AZA would influence on the outcome of the graft kidney, we analyzed the incidence of acute rejection episodes and one year graft survival rate after minimizing influences of donor factors by grafting the same cadaveric donor kidney.
METHODS
From April, 1998 to January, 2000, sixty eight patients grafted by 34 cadaver donors were enrolled in our study. From the same donor, one was randomly assigned to the MMF group(n=34) who were treated with cyclosporine, MMF, prednisolone while the other kidney was assigned to the AZA group(n=34) with cyclosporine, AZA, prednisolone. We analyzed the incidence of acute rejection episodes and CMV infection within the first 6 months of renal transplantation and one year graft survival rate was studied prospectively.
RESULTS
There were no significant differences in sex, HLA mismatch, cold ischemic time, and patients' weight between two group. Acute rejection or treatment failure occurred in 35.3% in the MMF group by 6 months after transplant, compared with 32.4% in the AZA group without statistic significance(12/34 vs. 11/34, p>0.05). One year graft survival rate was 91.2% and 97.1%, respectively, and CMV infection was documented in 4 patients(1/34 vs. 3/34, p>0.05).
CONCLUSION
There were no significant differences in the incidence of acute rejection episodes and one year graft survival rate between two groups. In contrast, previous studies showed that MMF could have lowered the incidence of acute rejection episodes and improved graft survival rate. This discrepancy in results might be explained that donor factors were important to cadaveric renal transplantation. Thus, we suggest that the influences of donor factors should be considered in further clinical study of cadaveric renal trans-plantation.