From mechanisms to long-term benefits.

Mycophenolate mofetil (MMF), a widely used immunosuppressant in solid organ transplantation, is a prodrug to deliver mycophenolic acid (MPA). MMF has been shown to decrease rejection rates and to improve graft survival, and probably accomplishes this through a variety of mechanisms. Its most prominent mechanism is to inhibit lymphocyte proliferation by inhibition of inosine monophosphate dehydrogenase. However, just as important to its overall beneficial effects are other mechanisms that include inhibition of proliferation of smooth muscle and fibroblasts, inhibition of antibody production, inhibition of lymphocyte adhesion and migration, and inhibition of nitric oxide synthase.