Therapeutic dose monitoring of MPA

A successful kidney transplant offers enhanced quality and duration of life and is more effective (medically and economically) than long-term dialysis therapy for patients with chronic or end-stage renal disease. MMF is recommended as a first-line anti-proliferative agent for initial maintenance therapy in kidney transplant recipients. Mycophenolate mofetil (MMF) and enteric coated Mycophenolate sodium (EC-MPS) have both been approved for use at a fixed dose in kidney transplantation. During the last few years, several large clinical trials and numerous pharmacokinetic studies have been reported that bring new insights to the debate of the clinical use of therapeutic drug monitoring (TDM) of MPA in kidney transplant recipients. However, the use of TDM for MPA remains controversial; some transplant teams have already implemented monitoring programs on a routine basis, whereas others never measure MPA exposure.The pharmacokinetics of MPA are characterized by a high inter-patient variability and a time-dependent change.