title: Correlations between cyclosporine concentrations at 2 hours post-dose and trough levels with functional outcomes in de novo lung transplant recipients.
abstract: BACKGROUND
  Although the reliability of cyclosporine (CyA) concentration at 2 (C2) hours postdosing has been established for kidney, liver, and heart transplant recipients, its use in lung cases remains to be validated. We investigated the relationship between CyA dual time point monitoring and long-term functional outcomes after lung transplantation.
  
  
  METHODS
  We included data from 38 lung transplant recipients receiving CyA, azathioprins, and steroids in the study. CyA dosages were based on the trough concentrations. CyA concentrations at 0 (C0) and 2 (C2) hours postdosing were obtained at 1, 2, 3, 6, 9, 12, 15, 18, and 24 months postoperative. We retrospectively compared average CyA level (C0 and C2) during the first 3 posttransplantation months with forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), forced expiratory flow 25%-75 % (FEF 25-75), creatinine, systolic blood pressure (SBP), and diastolic blood pressure (DBP) using regression analysis via generalized estimating equations (GEE).
  
  
  RESULTS
  Only improvement in FVC (P = .033) and deterioration of SBP (P < .001) were related to C0 monitoring. No correlation was observed between C0 and FEV1 (P = .13), FEF 25-75 (P = .48), creatinine (P = .07), and DBP (P = .97). Nor was any relationship observed between C2 concentrations and FEV1 (P = .64), FVC (P = .38), FEF 25-75 (P = .09), creatinine (P = .95), SBP (P = .73), or DBP (P = .51).
  
  
  CONCLUSIONS
  There was a lack of a relationship between CyA concentrations (C0 and C2) and functional outcomes among de novo lung transplantations except for a positive correlation of 0 value with long-term improved FVC and increased SBP. This study suggested that C2 determinations may not improving lung recipient management.
authors.affiliation: Lung Transplant and Biostatistics Units, Centre Hospitalier Universitaire Mont-Godinne, Université Catholique de Louvain, Yvoir, Belgium.
authors.forename: N
authors.initials: N
authors.lastname: Maziers
authors.forename: P
authors.initials: P
authors.lastname: Bulpa
authors.forename: J
authors.initials: J
authors.lastname: Jamart
authors.forename: L
authors.initials: L
authors.lastname: Delaunois
authors.forename: Ph
authors.initials: P
authors.lastname: Eucher
authors.forename: P
authors.initials: P
authors.lastname: Evrard
mesh_terms: D000328:Adult; D000368:Aged; D001379:Azathioprine / Q000008:administration & dosage; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D003404:Creatinine / Q000097:blood; D016572:Cyclosporine / Q000008:administration & dosage / Q000097:blood* / Q000493:pharmacokinetics; D016903:Drug Monitoring; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000097:blood* / Q000493:pharmacokinetics; D008168:Lung / Q000503:physiopathology; D016040:Lung Transplantation / Q000009:adverse effects / Q000276:immunology*; D008297:Male; D008450:Maximal Midexpiratory Flow Rate; D008875:Middle Aged; D012189:Retrospective Studies; D013256:Steroids / Q000008:administration & dosage; D016896:Treatment Outcome; D014797:Vital Capacity
chemical_list: D015415:Biomarkers; D007166:Immunosuppressive Agents; D013256:Steroids; D016572:Cyclosporine; D003404:Creatinine; D001379:Azathioprine