97th DOG Annual Meeting 1999
IMMUNOSUPPRESSIVE THERAPY WITH MYCOPHENOLATE MOFETIL (CELLCEPTÒ) FOR THE PREVENTION OF CORNEAL GRAFT REJECTION IN HIGH RISK PATIENTS
B. Aboalchamat1, N. Stübiger 2, M. Zierhut2, A. A. Bialasiewicz1,
The immunosuppressive therapy for high risk patients may be associated with severe side effects. Mycophenolate mofetil (MMF) has been proved to be an efficient and safe immunosuppressant in prevention of transplant rejection after renal and heart transplantation. The aim of this multicenter study is to evaluate the efficiency of MMF for the prevention of corneal graft rejection in high risk patients.
Method: In a prospective study, 21 high risk patients (mean age: 58.5 years) were treated with 2 x 1g MMF daily after penetrating keratoplasty. The follow-up period ranged between 6-27 months. Systemic steroids during the first 8 weeks postoperatively were added to the therapy regimen by all patients. In 5 patients, the immunosuppressive therapy was induced with MMF due to severe side effects or rejection episodes under systemic cyclosporin A therapy. At the follow-ups, slit lamp examination and blood parameter controls were obtained, and subjective side effects were asked for.
Results: No transplant rejection was observed in 20 patients during the follow-up period. 1 patient showed a decompensation of the corneal graft. The sutures were removed in 4 patients and the immunosuppression was terminated subsequently. Symptoms of underlying diseases such as atopic eczema (n=2), psoriasis (n=3) and rheumatoid arthritis (n=1) improved under the therapy with MMF. 2 patients suffered from tolerable side effects such as fatigue, inappetance and headache, however only during initiating the MMF therapy.
Conclusion: The immunosuppression with MMF as monotherapy was able to prevent the corneal graft rejection in high risk patients, showing tolerable side effects. A multicenter study is required in order to compare MMF with other immunosuppressants.
1 Universitäts-Augenklinik, Martinistrasse 52, D-20246 Hamburg
2 Universitäts-Augenklinik, Schleichstrasse 12, D-72076 Tübingen