Abstract:

BACKGROUND: It has an important clinical significance for the individual administration to perform the long-term and periodic blood drug level monitoring on the patients who use cyclosporin A.
OBJECTIVE: To summary the methods to monitor the cyclosporin A blood drug level and the influencing factors in order to provide the reference for the clinical using of cyclosporin A safely and effectively. 
METHODS: A computer-based search was performed for the articles from January 2000 to January 2012 with the key words of “Cyclosporin A, Renal Transplantation, blood drug level”. The articles relate to the immunosuppressive therapy by cyclosporin A after renal transplantation and the detection of the blood drug level, as well as the articles relate to the detection methods of cyclosporin A and the influencing factors of the cyclosporin A blood drug level were involved. The repetitive articles and the Meta analysis were eliminated and finally a total of 30 articles were included to review.  
RESULTS AND CONCLUSION: Due to the narrow therapeutic window and large bioavailability difference of cyclosporin A, the dose of cyclosporin A given in the first time was based on body mass in general, and the dose of the following administration was adjusted according to the concentration of cyclosporin A. The blood drug level was detected by fluorescence polarization immunoassay and high performance liquid chromatography, and predicted by artificial neural network at the same time. Drug interactions and the pathophysiological factors of the patients should be considered when adjust the dose of the administration. During the treatment after renal transplantation, the routine monitoring of the cyclosporin A blood drug level should be performed in order to maintain the blood drug level stability. Meanwhile, comprehensive consider the clinical factors, timely adjust the concentration of the administration and take the individual administration program in order to get the best treatment effect after renal transplantation.