Viral infections constitute an important problem for transplant recipients and their physicians. Often the balance between adequate and over-immunosuppression is hard to find and therapeutic drug monitoring might be a welcome adjunct in the management of transplant patients. We report four renal transplant recipients with extra-ordinary presentations of viral disease who were all treated with mycophenolate mofetil and in whom high mycophenolic acid (MPA) trough levels were found. High MPA levels may reflect over-immunosuppression resulting in infectious complications.

Cytomegalovirus, Infection, Mycophenolate mofetil, Mycophenolic acid, Therapeutic drug monitoring, Transplantation,
Transplant Infectious Disease
Department of Virology

Smak Gregoor, P.J.H, van Gelder, T, van Riemsdijk-van Overbeeke, I.C, Vossen, A.C.Th.M, IJzermans, J.N.M, & Weimar, W. (2003). Unusual presentation of herpes virus infections in renal transplant recipients exposed to high mycophenolic acid plasma concentrations. Transplant Infectious Disease, 5(2), 79–83. doi:10.1034/j.1399-3062.2003.00012.x