1. The objective of this study was to examine the association of UGT1A9, SLCO, and ABCC polymorphisms with
mycophenolic acid (MPA) pharmacokinetics in ABO blood type (ABO) incompatible patients with severe renal dysfunction pre-
transplantation. 2. In all patients, on day 14 after beginning
mycophenolate mofetil (MMF) treatment (1 week before
transplantation) and on day 28 after
renal transplantation, samples were collected just prior to and 1, 2, 3, 4, 6, 9, and 12 h after oral MMF administration. 3. The median dose-adjusted AUC0-12 of MPA after
renal transplantation was significantly lower than before
transplantation (57.9 versus 76.5 μg h/mL, respectively, p = 0.002). 4. Although the enterohepatic circulation of MPA pre-
transplantation was extremely high (57.6%), this level was significantly reduced after
renal transplantation (34.6%). 5. In the multivariate analysis, pre-
transplantation, patients with the SLCO1B3 334T allele (p = 0.003), higher
alanine aminotransferase (p = 0.002), and lower
body weight were independently predictive for a higher dose-adjusted AUC0-12 of MPA. 6. In patients with severe renal dysfunction pre-
transplantation, MPA is excreted mainly to bile from the liver, and as a consequence, the SLCO1B3 334T > G polymorphism was found to be significantly associated with MPA exposure.