Impact of C2 measurement on cyclosporine Neoral dosing in a Latin-American transplant program: the Guatemalan experience.
Optimal dosing of cyclosporine is difficult in transplant recipients. The introduction of the microemulsion Neoral in 1997 into our program and the measurement of C2 levels since 2000 in our center has allowed for more accurate individual dose finding. In our series, 141 transplant recipients (92 de novo, 49 maintenance) were followed for a 3-year period with C2 monitoring and serum creatinine levels as well as creatinine clearance studies. Biopsy proven acute rejection episodes appeared in three patients. The target levels of C2 during the first week were of vital importance to prevent acute rejection. Targets for the later periods of our study were somewhat lower than those recommended in North American or European studies. Even so, the incidence of acute rejection was low (3.2% for the de novo group). We feel that special populations like ours (mostly Mayan) deserve more attention regarding the finding of the optimal dose for immunosuppressive therapy after kidney transplantation.
García-Gallont
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Transplantation Unit, Hospital General San Juan de Dios, Guatemala City, Guatemala. garciagallont@hotmail.com
Toledo Solares
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D000328:Adult; D001379:Azathioprine / Q000627:therapeutic use; D003404:Creatinine / Q000097:blood; D016572:Cyclosporine / Q000097:blood / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D016903:Drug Monitoring / Q000379:methods; D004359:Drug Therapy, Combination; D006166:Guatemala; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology / Q000502:physiology*; D012189:Retrospective Studies
D016572:Cyclosporine; D003404:Creatinine; D001379:Azathioprine