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Outcome of microemulsion cyclosporine C 2 concentration monitoring in kidney transplantation
Author(s) -
Praditpornsilpa Kearkiat,
Avihingsa Yingyos,
Nivatvong Supanit,
Kansanabuch Talerngsak,
EiamOng Somchai,
Tiranathanagul Kajon,
Chusil Sauwaluck,
Tungsanga Kriang
Publication year - 2005
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 - 10.1111/j.1399-0012.2005.00343.x
Subject(s) - medicine , transplantation , creatinine , therapeutic drug monitoring , kidney transplantation , cohort , renal function , gastroenterology , urology , pharmacokinetics , surgery
Profiling of absorption of cyclosporine (CsA) microemulsion is a concept in therapeutic drug monitoring (TDM) designed to optimize the clinical benefits of the drug in transplant recipients. A single blood concentration at 2 h (C 2 ) after CsA microemulsion administration in kidney transplant recipients accurately predicts graft outcome. An international guidelines has recommended the target C 2 over time‐course post‐transplantation. We determined whether this recommendation is appropriate for our patients who are Asian ethnic. The clinical data of these C 2 monitoring kidney transplant recipients were compared with the historical cohort of microemulsion CsA trough (C 0 ) level monitoring during the first 24‐month post‐transplantation. The inclusion and exclusion criteria were applied for both C 2 and C 0 cohorts. The mean target C 2 concentrations at 1, 3, 6, and 12‐month post‐transplantation were achieved in the C 2 cohort as the international guildlines. At 3‐month post‐transplantation, patients who had C 2 concentrations over 1500 ng/mL had higher serum creatinine as compared with those who had C 2 levels <1300 ng/mL (2.23 ± 0.8 vs. 1.44 ± 0.38 mg/dL: p = 0.01). Also, at 6‐month post‐transplantation, patients who had C 2 concentrations over 1300 ng/mL had higher serum creatinine (1.96 ± 0.29 vs. 1.37 ± 0.34 mg/dL: p < 0.01) as compared with those who had C 2 levels <1100 ng/mL. There was no statistical difference of acute rejection episodes between the two cohorts. The international consensus for C 2 concentraion may be too high for Asian ethnic kidney transplant recipients. The data from this study indicated lower than recommended C 2 concentraion as an appropriate C 2 target concentraion.