A total of 40 highly sensitized patients were treated orally with MPA. All patients had T-cell PRA values greater than 30 % (73 % of patients were ¡Ý 75 % ). The PRAs, T-cell/B-cell flow cytometry crossmatch (FCXM) mean channel shift (MCS), patient/graft survival, acute rejection, and serum creatinine (SCr) were recorded.
All 40 patients showed a decrease in PRA levels. Eighteen of the 40 patients (40 % ) received a transplant. All four living donor recipients converted to a negative crossmatch. There was a significant decrease in FCXM MCS in all 18 transplanted patients. The mean SCr at 24 months was 1.00 ¡À 0.25 mg/dL. Five patients (28 % ) experienced acute rejection. The overall one year actuarial patient and graft survival were 94 % and 88 % , respectively.
These findings suggest that MPA therapy is effective in reducing PRAs and increases the likelihood of successful transplantation in sensitized recipients in a potentially simpler and more cost effective manner than the current regimens employed.