{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:29:37Z","timestamp":1753878577499,"version":"3.41.2"},"reference-count":17,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,6,19]],"date-time":"2018-06-19T00:00:00Z","timestamp":1529366400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To evaluate the effect of mycophenolate (mycophenolic acid, <jats:styled-content style=\"fixed-case\">MPA<\/jats:styled-content>) dose on pancreas allograft survival following simultaneous pancreas kidney (<jats:styled-content style=\"fixed-case\">SPK<\/jats:styled-content>) transplant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was an observational study of adult <jats:styled-content style=\"fixed-case\">SPK<\/jats:styled-content> recipients transplanted between 1\/1\/2002 and 6\/30\/2015. Recipients were divided into cohorts based on <jats:styled-content style=\"fixed-case\">MPA<\/jats:styled-content> dose at discharge: high dose (<jats:styled-content style=\"fixed-case\">HD<\/jats:styled-content>), 1000\u00a0mg three times daily mycophenolate mofetil (<jats:styled-content style=\"fixed-case\">MMF<\/jats:styled-content>) and standard dose (<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>), 1000\u00a0mg twice daily <jats:styled-content style=\"fixed-case\">MMF<\/jats:styled-content>. Primary outcome was pancreas allograft survival. Secondary endpoints included kidney allograft survival, pancreas allograft rejection, infection, time to initial dose decrease, and patient survival (<jats:styled-content style=\"fixed-case\">PS<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In all, 453 patients met inclusion criteria: 324 in <jats:styled-content style=\"fixed-case\">HD<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">MPA<\/jats:styled-content> group and 129 in <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">MPA<\/jats:styled-content> group. <jats:styled-content style=\"fixed-case\">HD<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">MPA<\/jats:styled-content> patients had higher rates of pancreas graft survival (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.003). There were no differences in rates of pancreas allograft rejection (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.8), kidney graft survival (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.15), overall infection (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.4), overall malignancy (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.93), time to first dose reduction (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.35), or patient survival (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.3). In a multivariable analysis adjusted for differences between groups and known confounders, dosing group continued to significantly affect incidence of pancreas allograft failure (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">HD<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">MPA<\/jats:styled-content> significantly impacted pancreas allograft survival in <jats:styled-content style=\"fixed-case\">SPK<\/jats:styled-content> recipients independent of graft rejection. Further studies are warranted to investigate the etiology of this finding and determine the optimal duration of <jats:styled-content style=\"fixed-case\">HD<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">MPA<\/jats:styled-content> associated with positive graft outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.13293","type":"journal-article","created":{"date-parts":[[2018,5,23]],"date-time":"2018-05-23T13:29:45Z","timestamp":1527082185000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of intensive dosing of mycophenolate on pancreas allograft survival"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1196-5110","authenticated-orcid":false,"given":"Jillian L.","family":"Descourouez","sequence":"first","affiliation":[{"name":"Department of Pharmacy University of Wisconsin Hospital and Clinics  Madison WI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6088-9727","authenticated-orcid":false,"given":"Margaret R.","family":"Jorgenson","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University of Wisconsin Hospital and Clinics  Madison WI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan","family":"Menninga","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University of Wisconsin Hospital and Clinics  Madison WI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glen","family":"Leverson","sequence":"additional","affiliation":[{"name":"Division of Transplantation Department of Surgery University of Wisconsin\u2010Madison School of Medicine and Public Health University of Wisconsin Hospital and Clinics  Madison WI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jon","family":"Odorico","sequence":"additional","affiliation":[{"name":"Division of Transplantation Department of Surgery University of Wisconsin\u2010Madison School of Medicine and Public Health University of Wisconsin Hospital and Clinics  Madison WI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Redfield","sequence":"additional","affiliation":[{"name":"Division of Transplantation Department of Surgery University of Wisconsin\u2010Madison School of Medicine and Public Health University of Wisconsin Hospital and Clinics  Madison WI 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