Exposure to mycophenolic acid at standard prescribed doses in renal transplantation recipients and clinical outcomes in the early posttransplantation period.

Introduction: Renal transplantation relies on effective immunosuppression. Mycophenolic acid (MPA), the active moiety of mycophenolate mofetil (MMF), is a crucial component. We investigated the relationship between exposure to MPA and early posttransplant outcomes. Methods: One hundred and twenty adult live-related renal transplant recipients receiving standard triple immunosuppression (Tacrolimus [Tac] tailored to C Results: About two-thirds of participants were males (77:23); the average age of the cohort was 35.86 ± 10.4 years. The mean MPA exposure was 63.7 ± 23.1 μg × h/mL. 66.6% of the participants had exposure outside the recommended therapeutic window (30-60 μg × h/mL); 55.8% were supra-therapeutic, whereas 10.8% subtherapeutic. Only 33.4% of patients had MPA concentrations within the therapeutic range. The MPA exposure was significantly high for participants who had infection (66.2 ± 26.6 μg × h/mL, Conclusion: We found that standard doses of 1.5-2 g/day MMF lead to overexposure of MPA in the majority of Indian renal transplant recipients in the early posttransplant period, and the higher exposure is linked to infections, underscoring the need for personalized mycophenolate dosing.