Serum Trough Concentration and Effects of Mycophenolate Mofetil Based on Pathologic Findings in Infants After Liver Transplantation

Ueno, Takehisa; Kodama, Tasuku; Noguchi, Yuki; Deguchi, Koichi; Nomura, Motonari; Saka, Ryuta; Watanabe, Miho; Tazuke, Yuko; Bessho, Kazuhiko; Okuyama, Hiroomi

doi:https://doi.org/10.1016/j.transproceed.2020.01.160

Serum Trough Concentration and Effects of Mycophenolate Mofetil Based on Pathologic Findings in Infants After Liver Transplantation

Ueno, Takehisa; Kodama, Tasuku; Noguchi, Yuki et al.

Transplantation Proceedings, 2020, 52(6), 1855-1857

Number of Access:1,047（2025-07-22 21:52 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/96476

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Title	Serum Trough Concentration and Effects of Mycophenolate Mofetil Based on Pathologic Findings in Infants After Liver Transplantation
Creator	NRID 1000010456957 1000010456957 ORCID 0000-0002-4639-8814 0000-0002-4639-8814 researchmap permalink ueno-pedsurg ueno-pedsurg Scopus Author ID 21743992300 21743992300 CreatorName Ueno, Takehisa
	NRID 1000060771045 1000060771045 CreatorName Kodama, Tasuku
	NRID 1000030771042 1000030771042 CreatorName Noguchi, Yuki
	NRID 1000000747082 1000000747082 researchmap permalink deguchi_koichi deguchi_koichi Scopus Author ID 57139781700 57139781700 CreatorName Deguchi, Koichi
	NRID 1000040546909 1000040546909 researchmap permalink moto_pedsurg moto_pedsurg Scopus Author ID 35208741700 35208741700 ORCID 0009-0004-0959-7461 0009-0004-0959-7461 CreatorName Nomura, Motonari
	NRID 1000000459190 1000000459190 ORCID 0000-0001-8960-8618 0000-0001-8960-8618 researchmap permalink sakaryuta sakaryuta CreatorName Saka, Ryuta
	NRID 1000040791728 1000040791728 researchmap permalink miho miho Scopus Author ID 56282966800 56282966800 ORCID 0000-0001-6691-0611 0000-0001-6691-0611 CreatorName Watanabe, Miho
	NRID 1000010397698 1000010397698 researchmap permalink yukotazuke-osaka yukotazuke-osaka Scopus Author ID 7006109798 7006109798 ORCID 0000-0002-8335-0414 0000-0002-8335-0414 CreatorName Tazuke, Yuko
	NRID 1000080423169 1000080423169 researchmap permalink KazuBe KazuBe CreatorName Bessho, Kazuhiko
	NRID 1000030252670 1000030252670 researchmap permalink okuyamahiroomi okuyamahiroomi Scopus Author ID 35496082300 35496082300 ORCID 0000-0002-1347-282X 0000-0002-1347-282X CreatorName Okuyama, Hiroomi
Description	Ueno T., Kodama T., Noguchi Y., et al. Serum Trough Concentration and Effects of Mycophenolate Mofetil Based on Pathologic Findings in Infants After Liver Transplantation. Transplantation Proceedings 52, 1855 (2020); https://doi.org/10.1016/j.transproceed.2020.01.160.
Abstract	Objectives: Mycophenolate mofetil (MMF) is mainly used in conjunction with calcineurin inhibitors as an additional immunosuppressive for renal sparing after liver transplantation. However, few reports about MMF use in infants after living donor liver transplantation (LDLT) are available. The purpose of this study was to examine the efficacy and safety of MMF in infants. Methods: This study enrolled infants younger than 1 year of age who received LDLT at our institution. Patients received oral MMF twice daily. The initial dose was 40 to 50 mg/kg/d, which was increased to a target mycophenolic acid (MPA) trough level of 2 mg/L. Body weight, height, MMF dose, MPA trough level, acute cellular rejection (ACR) episodes, pathologic findings, and adverse effects were analyzed. Allograft fibrosis was graded using the Meta-analysis of Histological Data in Viral Hepatitis score. Results: Patients received MMF for refractory ACR (n = 2), fulminant hepatitis (n = 2), and pre-existing antibodies (n = 1). Original diseases were biliary atresia (n = 3) and fulminant hepatitis (n = 2). Mean age at transplant was 8 months (range 3-10 months). The last available mean trough level was 2.7 mg/L. The mean dose was 66 mg/kg/d or 1429 mg/m2/d at the time of the last available through level. The regression line for MMF dose and MPA trough level was y = 1.8 × 10-3x. The correlation coefficient was 0.65. All allografts showed F1 to F2 fibrosis. Two patients discontinued MMF because of infection and bone marrow suppression, respectively. Two patients converted to everolimus. One patient continued on MMF. Conclusions: After LDLT, infants require a higher MMF dose than older patients based on trough levels, but allograft fibrosis can progress.
Publisher	Elsevier Inc.
Source Title	Transplantation Proceedings
Volume (Issue)	52(6)
Page	1855-1857
Date of Issued	2020-07-01
Language	English
Handle URL	https://hdl.handle.net/11094/96476
PISSN	00411345
eISSN	18732623
Relation.isVersionOf	DOI (Publisher Version) https://doi.org/10.1016/j.transproceed.2020.01.160
Access Rights	open access
CopyRight	© 2020. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
oaire:version	Accepted Manuscript
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCTERMS.bibliographicCitation	Transplantation Proceedings. 2020, 52(6), p. 1855-1857
DC.title	Serum Trough Concentration and Effects of Mycophenolate Mofetil Based on Pathologic Findings in Infants After Liver Transplantation
DC.creator	Ueno, Takehisa
	Kodama, Tasuku
	Noguchi, Yuki
	Deguchi, Koichi
	Nomura, Motonari
	Saka, Ryuta
	Watanabe, Miho
	Tazuke, Yuko
	Bessho, Kazuhiko
	Okuyama, Hiroomi
DC.publisher	Elsevier Inc.
DC.language' scheme='DCTERMS.RFC1766	English
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2020-07-01
DC.identifier	https://doi.org/10.1016/j.transproceed.2020.01.160
DC.description	Ueno T., Kodama T., Noguchi Y., et al. Serum Trough Concentration and Effects of Mycophenolate Mofetil Based on Pathologic Findings in Infants After Liver Transplantation. Transplantation Proceedings 52, 1855 (2020); https://doi.org/10.1016/j.transproceed.2020.01.160.
DCTERMS.abstract	Objectives: Mycophenolate mofetil (MMF) is mainly used in conjunction with calcineurin inhibitors as an additional immunosuppressive for renal sparing after liver transplantation. However, few reports about MMF use in infants after living donor liver transplantation (LDLT) are available. The purpose of this study was to examine the efficacy and safety of MMF in infants. Methods: This study enrolled infants younger than 1 year of age who received LDLT at our institution. Patients received oral MMF twice daily. The initial dose was 40 to 50 mg/kg/d, which was increased to a target mycophenolic acid (MPA) trough level of 2 mg/L. Body weight, height, MMF dose, MPA trough level, acute cellular rejection (ACR) episodes, pathologic findings, and adverse effects were analyzed. Allograft fibrosis was graded using the Meta-analysis of Histological Data in Viral Hepatitis score. Results: Patients received MMF for refractory ACR (n = 2), fulminant hepatitis (n = 2), and pre-existing antibodies (n = 1). Original diseases were biliary atresia (n = 3) and fulminant hepatitis (n = 2). Mean age at transplant was 8 months (range 3-10 months). The last available mean trough level was 2.7 mg/L. The mean dose was 66 mg/kg/d or 1429 mg/m2/d at the time of the last available through level. The regression line for MMF dose and MPA trough level was y = 1.8 × 10-3x. The correlation coefficient was 0.65. All allografts showed F1 to F2 fibrosis. Two patients discontinued MMF because of infection and bone marrow suppression, respectively. Two patients converted to everolimus. One patient continued on MMF. Conclusions: After LDLT, infants require a higher MMF dose than older patients based on trough levels, but allograft fibrosis can progress.
DC.rights	© 2020. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
DC.format	96476
citation_title	Serum Trough Concentration and Effects of Mycophenolate Mofetil Based on Pathologic Findings in Infants After Liver Transplantation
citation_author	Ueno, Takehisa
	Kodama, Tasuku
	Noguchi, Yuki
	Deguchi, Koichi
	Nomura, Motonari
	Saka, Ryuta
	Watanabe, Miho
	Tazuke, Yuko
	Bessho, Kazuhiko
	Okuyama, Hiroomi
citation_publisher	Elsevier Inc.
citation_language	English
citation_date	2020-07-01
citation_journal_title	Transplantation Proceedings
citation_volume	52
citation_issue	6
citation_firstpage	1855
citation_lastpage	1857
citation_doi	https://doi.org/10.1016/j.transproceed.2020.01.160
citation_public_url	https://hdl.handle.net/11094/96476

Serum Trough Concentration and Effects of Mycophenolate Mofetil Based on Pathologic Findings in Infants After Liver Transplantation

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