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Fellowship Program Leadership

Director-
Matthew A. Sparks, MD

Associate Director-
Harpreet Singh, MD

Associate Director-
Rasha Raslan, MD

Program Coordinator-
Ashley McPherson

Chief Fellow-
Ale Tomasi, MD

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How to interpret mycophenolic acid levels

  • Serum trough levels of mycophenolic acid (MPA) at steady-state (>2weeks at the same dose) in the range of 1.0-3.5 mcg/mL indicate adequate therapy. MPA is the active metabolite.
  • Mycophenolic acid glucuronide (MPA-G) levels in the range of 35 to 100 mcg/mL indicate that the patient has normal uridine diphosphate glucuronosyltransferase (UGT) metabolic capacity. MPA-G is inactive and describe the patient’s metabolic status.
  • Trough steady-state serum MPA levels >4.0 mcg/mL indicate that the patient is overimmunosuppressed and susceptible to systemic infections.
  • Decreased dosages may be indicated in these cases.
  • Low MPA levels and high MPA-G levels suggest that the patient has an active UGT metabolic capability; higher doses may be required to maintain therapeutic levels of MPA.
  • Patients who have low UGT conjugating capability may become overimmunosuppressed, indicated by a trough steady-state serum MPA level >4.0 mcg/mL and a MPA-G level <40 mcg