Analysis of Infections in Renal Transplant Recipients Receiving Mycopheolate Versus Azathioprine-based Immunosuppression

Lee, Jae Chang; Ko, Suk Whan; Oh, Soo Myung; Park, Ho Chul

Abstract

PURPOSE
Immunosuppression is important for early success of renal transplantation. Mycofenolate mofetil (MMF) has been substituted for Azathioprine (AZA) and has been shown to have greater effect on T cell and also on B cell function than AZA. Although many side effects like infections have been investigated in patients who received AZA based therapy, they have not extensively been studied in MMF based protocol. The aim of this study is to evaluate the differences in incidence and frequency of infections during the first 6 months in the patients who received AZA or MMF based therapy.
METHODS
Renal transplant recipients who received either AZA or MMF based therapy were reviewed. From January 1994 to December 2003, 112 patients were enrolled and analyzed the types and frequency of infection.
RESULTS
78 patients received AZA based therapy, and 34 patients received MMF based therapy. Infection developed in 37 (47.4%) and 12 (35.3%) patients respectively. AZA group showed higher incidence of infection than MMF group (P<0.05). In AZA group, UTI developed in 15 patients (19.2%), URI in 7 patients(9%), CMV infection in 7 patients (9%), tuberculosis in 2 patients (2.6%), and wound infection in 6 patients (7.7%). In MMF group, UTI developed in 6 patients (17.6%), URI in 2 patients (5.9%), CMV infection in 2 patients (5.9%), tuberculosis in 1 patient (2.9%), wound infection in 1 patient (2.9%). There were no significant differences in the type of various infectious episodes between two groups.
CONCLUSION
AZA group showed higher incidence in total infection, but there were no differences in the type of various infectious episodes between two groups. MMF has more powerful immunosuppressive effect (18) but has similar infectious adverse effects compared with AZA.