Clinical outcome after cyclosporine dose reduction based on C2 levels in long-term liver transplant patients.
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.
Tha-In
Thanyalak
T
Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center, Dr Molewaterplein, Rotterdam, The Netherlands. t.tha-in@erasmusmc.nl
Hesselink
Dennis A
DA
Tilanus
Hugo W
HW
Elshove
Lara
L
Wilschut
Anneloes L
AL
Hansen
Bettina E
BE
van Gelder
Teun
T
Metselaar
Herold J
HJ
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
D016572:Cyclosporine; D003404:Creatinine