Prediction of acute graft rejection in renal transplantation: the utility of cyclosporine blood concentrations.

摘要: While cyclosporine is recommended to be used only in conjunction with monitoring of its blood concentrations, the utility these measurements preventing treatment failure not established. In a group 52 patients trough levels and steady-state concentrations were monitored serum whole by specific (SP) nonspecific (NS) assays (polyclonal radioimmunoassay, PR; fluorescence polarization immunoassay, FP; high-pressure liquid chromatography, HP). From as many 10 determinations level steady state during first 40 days after renal transplantation, lowest measurement was selected. case an acute rejection episode within that time period, values until event considered. Trough PR/NS FP/NS HP/SP significantly different between without episodes. However, simultaneously measured (serum/PR/NS serum/FP/NS) lower suffering from (with SS/ serum/PR/NS mean = 127 ng/ml, SD 41 ng/ml; 163 60 P 0.027, t test). This difference could demonstrated for state/whole blood/HP/SP measurements. A logistic regression analysis probability can decreased up 40% if state/serum/PR/NS or state/serum/FP/NS never drop below 250 ng/ml early transplantation.