Comparative Analysis of Adverse Effects and Graft Rejection Rates of Azathioprine versus Mycophenolate in Kidney Transplant Recipients: A Retrospective Study

Abstract

Azathioprine, one of the oldest immunosuppressive agents, has been widely used for preventing graft rejection, while mycophenolate mofetil has shown superior efficacy in preventing acute rejection in randomized controlled trials. However, both drugs share significant side effects, such as bone marrow suppression and an increased risk of cytomegalovirus infection. This study aimed to compare the effectiveness and safety of azathioprine and mycophenolate mofetil in kidney transplantation. A retrospective observational study was conducted at Ahmed Gasim Teaching Hospital, involving adult kidney transplant recipients in 2021 who received either azathioprine or mycophenolate as part of their maintenance immunosuppressive regimen. Data were collected and analyzed using SPSS software, with statistical significance defined as a p-value of less than 0.05. The results revealed that 81% of azathioprine recipients and 70.6% of mycophenolate recipients experienced adverse effects. The incidence of acute rejection was low in both groups (17.2% for azathioprine and 25% for mycophenolate), with survival rates close to 100% in both groups (98.3% for azathioprine and 98.5% for mycophenolate). No significant differences were found between the two groups in terms of patient survival, adverse effect occurrence, or rejection rates. The study concludes that both azathioprine and mycophenolate are equally effective in preventing acute graft rejection and achieving high survival rates, with no significant difference in overall outcomes.