title: Cyclosporine trough (C0) and 2-hour postdose (C2) levels: which one is a predictor of graft loss?
abstract: BACKGROUND
  Compared with conventionally measured trough level (C0), cyclosporine 2-hour postdose (C2) concentrations show a better correlation with the area under the curve and acute graft rejection.
  
  
  OBJECTIVE
  We evaluated the relationships of C0 and C2 with long-term graft survival among kidney transplant recipients.
  
  
  METHODS
  In a case-control design, we selected 215 adult kidney recipients. Inclusion criteria were more than 18 years of age at transplantation and at least 6 months of follow-up. The case group consisted of patients with graft loss (n=17) and a control group, patients with functioning grafts (n=198). The C0 and C2 levels for the first 6 months posttransplantation, along with demographic and clinical data, were compared between the two groups using univariate analysis. P<.05 was considered to be significant.
  
  
  RESULTS
  The mean age at transplantation was 40.5 +/- 16.5 years. The mean follow-up duration was 18 +/- 14 months. The mean C0 values for the case and control groups were 257.8 +/- 126.5 and 248.5 +/- 104.4 mumol/L, respectively (P>.05). The values for C2 were 712.7 +/- 273.2 and 886.2 +/- 266.9 mumol/L, respectively (P=.01).
  
  
  CONCLUSIONS
  We observed that C2, but not C0, in the first 6 months posttransplantation were a predictor of long-term graft survival. The findings here in supported the results of other studies that have proposed cyclosporine concentration monitoring by C2 rather than C0 measurements.
authors.affiliation: Nephrology/Urology Research Center (NURC), Baqiyatallah Medical Sciences University, Tehran, Iran. eghlim.nemati@gmail.com
authors.forename: E
authors.initials: E
authors.lastname: Nemati
authors.forename: B
authors.initials: B
authors.lastname: Einollahi
authors.forename: S
authors.initials: S
authors.lastname: Taheri
authors.forename: M
authors.initials: M
authors.lastname: Moghani-Lankarani
authors.forename: E
authors.initials: E
authors.lastname: Kalantar
authors.forename: N
authors.initials: N
authors.lastname: Simforoosh
authors.forename: M
authors.initials: M
authors.lastname: Nafar
authors.forename: A R
authors.initials: AR
authors.lastname: Saadat
mesh_terms: D000328:Adult; D016572:Cyclosporine / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D007700:Kinetics; D008875:Middle Aged; D018579:Patient Selection; D011237:Predictive Value of Tests; D017741:Survivors; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine