title: Clinical outcome after cyclosporine dose reduction based on C2 levels in long-term liver transplant patients.
abstract: BACKGROUND
  Recent studies suggest that cyclosporine dose adjustment based on C2 levels results in improvement of renal function. This study investigates the effect on renal function after dose reduction based on the C2 levels in long-term liver transplant patients.
  
  
  METHODS
  In 60 patients (>1 yr after transplantation), C2 levels were assessed (target 600 ng/mL +/- 20%). Dose reduction was performed when C2 >720 ng/mL. Serum creatinine concentrations were measured and creatinine clearance was calculated.
  
  
  RESULTS
  Twenty-three patients (38%) had C2 values >720 ng/mL. After dose reduction, mean cyclosporine dose decreased by 25% (p < 0.01). Mean C2 value decreased by 42% (p < 0.01). Serum creatinine concentrations remained stable. After dose reduction two patients experienced recurrence of PBC, in one patient AIH recurred and rejection was diagnosed in one patient.
  
  
  CONCLUSIONS
  Cyclosporine C2 concentrations above 720 ng/mL are common in long-term liver transplant patients. Dose reduction of 25% did not improve kidney function and was accompanied by immune activation.
authors: Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center, Dr Molewaterplein, Rotterdam, The Netherlands. t.tha-in@erasmusmc.nl
authors: Thanyalak
authors: T
authors: Tha-In
authors: Dennis A
authors: DA
authors: Hesselink
authors: Hugo W
authors: HW
authors: Tilanus
authors: Lara
authors: L
authors: Elshove
authors: Anneloes L
authors: AL
authors: Wilschut
authors: Bettina E
authors: BE
authors: Hansen
authors: Teun
authors: T
authors: van Gelder
authors: Herold J
authors: HJ
authors: Metselaar
mesh_terms: D003404:Creatinine / Q000378:metabolism; D016572:Cyclosporine / Q000008:administration & dosage* / Q000097:blood*; D005260:Female; D006084:Graft Rejection; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007668:Kidney / Q000502:physiology*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D013997:Time Factors
chemical_list: D016572:Cyclosporine; D003404:Creatinine