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Relationship between endomyocardial biopsy score and cyclosporine 2‐h post‐dose levels (C 2 ) in heart transplant patients receiving anti‐thymocyte globulin induction
Author(s) -
Cantarovich Marcelo,
Giannetti Nadia,
Cecere Renzo
Publication year - 2004
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1046/j.1399-0012.2003.00138.x
Subject(s) - medicine , anti thymocyte globulin , transplantation , gastroenterology , heart transplantation , liver transplantation , immunosuppression , biopsy , surgery
Background: Cyclosporine (CsA) 2‐h post‐dose levels (C 2 ) correlate better with the area‐under‐the‐curve compared with trough levels. The purpose of this study was to determine the relationship between C 2 and endomyocardial biopsy (EMB) score in heart transplant patients receiving anti‐thymocyte globulin (ATG)‐induction. Methods: We reviewed 517 EMB performed during the first year in 39 adult heart transplant patients receiving ATG‐induction, corticosteroids, mycophenolate mofetil and CsA. C 2 obtained on the day of EMB was related to the International Society for Heart and Lung Transplantation classification (score ≤2 or ≥3A). Furthermore, EMB were related to C 2 (ng/mL), sorted according to the lower recommended range in liver (0–3 months: 850; 4–6 months: 700; 7–12 months: 500) or renal transplantation (0–1 month: 1500; 2–3 months: 1200; 4–6 months: 1000; 7–12 months: 800). Results: Overall, C 2 did not significantly differ in patients with EMB ≤2 or ≥3A. However, during the first month, EMB ≤2 was associated with a trend towards a higher mean C 2 compared with EMB ≥3A (750 ng/mL vs. 530 ng/mL). When C 2 were sorted according to the lower recommended range in liver or renal transplantation, no significant difference was observed when EMB was ≤2 or ≥3A. Conclusion: In heart transplant patients receiving ATG‐induction, C 2 did not significantly differ according to EMB ≤2 or ≥3A. No significant relationship was found between EMB score and C 2 based on the lower recommended range in liver or renal transplantation. However, mean C 2 >750 ng/mL appears to be associated with a lower rejection score during the first month.