Cyclosporin A absorption profiles in pediatric renal transplant recipients predict the risk of acute rejection.

摘要: The current focus of cyclosporin A (CsA) monitoring in adult transplantation for optimized immunosuppression is on the early portion CsA area under concentration-time curve (AUC), particularly first 4 hours postdose, designated as AUC(0-4), and blood concentration 2 postdose (C2) a highly predictive marker AUC(0-4). Because data pediatric patients are scarce, full-time (12 hours) absorption profiles were analyzed relation to effectiveness 61 renal transplant recipients aged 3.2 17.4 years an immunosuppressive triple regimen with CsA, mycophenolate mofetil, methylprednisolone. dosing was based body surface adjusted trough levels. Pharmacokinetic (PK) obtained 1 3 weeks (initial period) 6 months posttransplant (stable period). Patients AUC(0-4) < 4400 microg x h/L at both PK sampling periods had relative risk 48.4% suffer acute rejection episode (ARE), whereas least AUC0-4 above this threshold, ARE only 13.1% (P 0.02). single parameters C0 or C2 did not discriminate between without rejection. C1.25 (r2 = 0.64) 0.60) showed stronger relationship profile (AUC(0-4)) than 0.15). An abbreviated consisting variables C(0.5;2) C(0;0.5;2) closest correlation 0.89) lowest percentage prediction error. These indicate that profiling has potential optimize therapy CsA.