5. Gastro-intestinal complaints in stable renal transplant recipients on tacrolimus and mycophenolate mofetil

Z. al Fatly, J.A. van Gestel, M.J. Verschragen, M.G.H. Betjes, A.E. de Weerd

Wednesday 4 march 2020

0:00 - 0:00h at Toon Hermans Foyer

Parallel session: Postersessie 1 – Klinische abstracts

Background: Gastro-intestinal complaints are frequently reported in renal transplant recipients. In a nested cohort study of a randomized weaning trial, we were able to systematically investigate the burden of gastro-intestinal complaints and the effect of mycofenoalte mofetil (MMF) on these complaints in stable renal transplant recipients.

Methods: Low immunological risk renal transplant recipients (HLA mismatches

Results: Of the 121 included patients, 2 discontinued MMF prior to randomization due to diarrhea. Of the 79 randomized patients, 72 patients completed all questionnaires (34 TACmono and 38 TAC/MMF). Mean age was 59 years with 72% male. At month 6, BMI was 28 kg/m², eGFR 55 ml/min/1,73m² and daily dose MMF 1200 mg and TAC 5,8 mg, with trough levels of 2.1 mg/L and 7.4 ug/L respectively.

Abdominal pain, reflux , indigestion and constipation did not differ between the groups and over time. Mean scores at month 6 were 1,8, 1,3, 1,8 and 1,7 respectively. At month 15 these scores were 1,6, 1,3, 1,8 and 1,8 respectively. Diarrhea, over time, was significantly more frequent with continuation of MMF (p =0,024).

Conclusions: Stable renal transplant recipients with immunological low risk experience mild gastro-intestinal complaints. Moreover, mycophenolate mofetil on top of tacrolimus causes more diarrhea in comparison to tacrolimus monotherapy.