Abstract:

BACKGROUND: Documents recorded that the correlation between micro emulsion Ciclosporin peak concentration (C2) and area under curve was best with maximum individual difference. According to C2, dose of Ciclosporin can be adjusted individually to decrease acute rejection and Ciclosporin toxicity, which has widely used in perioperative stage of renal transplanted recipients. However, some transplantation center still used tough concentration (C0) to adjust the dose of Ciclosporin in stable stage of renal transplanted recipients.
OBJECTIVE: To analyze the efficacy and safety of changing from monitoring C0 to C2 in stable stage recipients following renal transplantation.
METHODS: Totally 65 patients with renal transplantation were enrolled in this study, including 31 males and 34 females, aged 20-57 (39.4±15.3) years. Within 3 months prior to this study, all patients did not suffered from rejection, and their serum creatinine and urea nitrogen were stable (creatinine ≤180 μmol/L). They were in stable stage after renal transplantation. Their period of transplantation and function of allograft were recorded. Their C0 and C2 of Ciclosporin were assayed. According to the target C2 value 500-600 μg/L, the patients were prospectively and randomly divided into 3 groups. In the high C2 group (n=17), the dose of Ciclosporin was decreased. In the target C2 group (n=23), the dose of Ciclosporin was remained. In the low C2 group (n=25), the dose of Ciclosporin was increased. All of the patients were followed-up for 12 months. The grafts function and the complications of heart, lung and brain were compared.
RESULTS AND CONCLUSION: According to the target concentration of Ciclosporin C2, the dose of Ciclosporin in the high C2 group was decreased by 575.0 mg. The Creatinine and urea nitrogen of 88% patients were stable, while blood pressure, blood fat and blood uric acid decreased in parts of patients. In the target C2 group, the levels of creatinine, urea nitrogen, C0 and C2 of patients were stable, no complications of heart, lung and brain occurred. According to the target concentration of Ciclosporin C2, the dose of Ciclosporin in low C2 group was increased by 755.0 mg. The creatinine and urea nitrogen of 84% patients were stable. All of the patients were no complications of heart, lung and brain. It is safe and effective to adjust Ciclospori dose under C2 monitoring according to the target peak concentration (500-600 μg/L) in most stable stage recipients following renal transplantation.