The effect of MMF dose and trough levels on adverse effects in pediatric heart transplant recipients

Nida Siddiqi, Jacqueline M. Lamour, Daphne T. Hsu

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Limited pharmacokinetic and safety data exist for MMF in pediatric HTR. Previously targeted MPA-TL are 1.5-3.0 μg/mL. The objective of this study was to assess the outcomes targeting MPA-TL of 0.8-2.0 μg/mL in pediatric HTR. MPA-TL were retrospectively collected 2-12 months post-transplant. Acute rejection, infection, leukopenia, and GI complaints were then correlated with MPA-TL. A total of 355 MPA-TL from 22 HTR were included. Median age was 2.5 yr. Primary indication for transplant was dilated cardiomyopathy (64%). Mean MPA-TL was 1.7 ± 0.9 μg/mL. African American patients received significantly higher doses (702 ± 235 mg/m2) compared with other races (p = 0.035). Leukopenia was less common in patients with SUB MPA vs. others (p = 0.01). MMF was discontinued for GI complaints in one patient and leukopenia in two patients. One SUB patient had acute rejection, and one SUP patient had infection. One-yr survival was 100%. Targeting a lower range for MPA-TL was not associated with significant rejection or infection. Despite lower MPA-TL, MMF was discontinued in 3/22 patients for adverse effects.

Original languageEnglish (US)
Pages (from-to)618-622
Number of pages5
JournalPediatric Transplantation
Issue number6
StatePublished - Sep 1 2015


  • cardiac transplantation
  • mycophenolate mofetil
  • pediatric heart transplant
  • therapeutic drug monitoring

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation


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