Approach to a target value for 2-hours post dose cyclosporine (C2) during the first week post renal transplantation.
BACKGROUND
There is not a wide consensus on whether recommended target ranges for 2-hours post dose cyclosporine (CsA) blood level (C2) are generalizeable to all kidney recipient populations worldwide. In this study we aimed to assess in which C2 level we can obtain the least acute rejection (AR) episodes in our kidney transplanted patients.


METHODS
In a retrospective cross-sectional study, we investigated all our renal recipients with at least a valid C2 blood level at the days between 5-9 post transplantation. All patients were under immunosuppressive therapy with CsA (Neoral), prednisolone and MMF.


RESULTS
Hundred forty-four patients were eligible for inclusion in the study. Mean age of the study subjects at the time of transplantation was 36.8+/-16.6 years. 99 (69%) of the patients were male. Overall, 16 (11%) patients experienced AR during the first two weeks post-transplantation. Mean C2 blood levels for patients experiencing AR was 793+/-335 compared with 1028+/-391 for patients without AR (p=0.023). We found that none of the patients with a C2 level of higher than 1300 ng/mL experienced an episode of AR.


CONCLUSIONS
According to our findings, we recommend that for minimization purpose of the incident AR episodes among LURD kidney, a C2 blood level of higher than 1300 ng/mL to be obtained during the first week post-transplantation. Alongside, approaching specific C2 targets for patients with different drug regimen or genetic polymorphisms seem necessary.
Einollahi
Behzad
B
Nephrology Research Center, Baqiyatallah Hospital, Tehran, Iran and Baqiyatallah University of Medical Sciences, Tehran, Iran. behzad.einollahi@gmail.com
Taheri
Saeed
S
Lessan-Pezeshki
Mhaboob
M
Pourfarziani
Vahid
V
Hosseini
Mahbobeh Sadat
MS
Nemati
Eghlim
E
Ghadiani
Mohammad Hassan
MH
Abbaszadeh
Shahin
S
Nourbala
Mohammad Hossein
MH
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D016572:Cyclosporine / Q000097:blood / Q000493:pharmacokinetics*; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000097:blood / Q000493:pharmacokinetics*; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012189:Retrospective Studies; D055815:Young Adult
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D003404:Creatinine