Cyclosporine A blood concentration during pregnancy in renal allograft recipients.
Pregnancy-induced changes increase hazards associated with cyclosporine (CsA) treatment. Blood CsA trough levels (C0) were estimated in 15 pregnant renal allograft recipients treated with prednisolone + CsA + azathioprine using the TDx Abbott fluorescent polarization immunoassay. Despite therapeutical dose levels of CsA administered during pregnancy (3.52-3.67 and 3.59 mg/kg body weight in the first, second, and third trimesters, respectively), C0 significantly decreased (first trimester 130.8 +/- 36.9, second 92.0 +/- 32.7, and third 99.0 +/- 36.9 ng/ml). The mean increase of patient's body weight in mid-pregnancy was 3.0 +/- 2.19 kg and was associated with a significant (P < 0.05) fall in a hematocrit value (from 42 +/- 4.9% prior to pregnancy to 34 +/- 6% at the 20th week). We postulate that C0 concentration does not reflect the true exposure to CsA as no episodes of acute graft rejection were observed during pregnancy.
Transplantation Institute, Warsaw Medical School, Poland.
B
B
Kozłowska-Boszko
Z
Z
Gaciong
A
A
Serafinowicz
J
J
Majchrzak
M
M
Durlik
W
W
Rowiński
M
M
Lao
D000328:Adult; D016572:Cyclosporine / Q000097:blood* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000097:blood* / Q000627:therapeutic use; D016030:Kidney Transplantation; D011247:Pregnancy
D007166:Immunosuppressive Agents; D016572:Cyclosporine