IngentaConnect Clinical outcome after cyclosporine dose reduction based on C2 le...

Authors: Tha-In, Thanyalak¹; Hesselink, Dennis A²; Tilanus, Hugo W³; Elshove, Lara¹; Wilschut, Anneloes L¹; Hansen, Bettina E; Gelder, Teun⁴; Metselaar, Herold J¹

Source: Clinical Transplantation, Volume 19, Number 4, August 2005 , pp. 537-542(6)

Publisher: Blackwell Publishing

Abstract:

Tha-In T, Hesselink DA, Tilanus HW, Elshove L, Wilschut AL, Hansen BE, van Gelder T, Metselaar HJ. Clinical outcome after cyclosporine dose reduction based on C₂ levels in long-term liver transplant patients.

Clin Transplant 2005: 19: 537–542. © Blackwell Munksgaard, 2005 Abstract: Background:

Recent studies suggest that cyclosporine dose adjustment based on C₂ levels results in improvement of renal function. This study investigates the effect on renal function after dose reduction based on the C₂ levels in long-term liver transplant patients. Methods:

In 60 patients (>1 yr after transplantation), C₂ levels were assessed (target 600 ng/mL ± 20%). Dose reduction was performed when C₂ >720 ng/mL. Serum creatinine concentrations were measured and creatinine clearance was calculated. Results:

Twenty-three patients (38%) had C₂ values >720 ng/mL. After dose reduction, mean cyclosporine dose decreased by 25% (p < 0.01). Mean C₂ value decreased by 42% (p < 0.01). Serum creatinine concentrations remained stable. After dose reduction two patients experienced recurrence of PBC, in one patient AIH recurred and rejection was diagnosed in one patient. Conclusion:

Cyclosporine C₂ concentrations above 720 ng/mL are common in long-term liver transplant patients. Dose reduction of 25% did not improve kidney function and was accompanied by immune activation.

Keywords: C2 immune activation; cyclosporine; liver transplantation; renal dysfunction

Document Type: Research article

DOI: 10.1111/j.1399-0012.2005.00385.x

Affiliations: 1: Department of Gastroenterology and Hepatology 2: Department of Internal Medicine, Renal Transplant Unit 3: Department of Surgery 4: Department of Hospital Pharmacy, Clinical Pharmacology Unit, Erasmus MC-University Medical Center, Dr Molewaterplein, Rotterdam, The Netherlands

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Clinical outcome after cyclosporine dose reduction based on C2 levels in long-term liver transplant patients

Clinical outcome after cyclosporine dose reduction based on C₂ levels in long-term liver transplant patients