Kidney transplantationImmunosuppressive protocolThe Area Under the Concentration-Time Curve Versus Trough and Peak Blood Level Monitoring in Renal Transplant Recipients on Cyclosporine
Section snippets
Methods
A prospective study of 65 randomized patients to evaluate C2 and AUC0–4 was conducted for 1 year. C0 and C2 were used to calculate AUC0–4 according to the Keown algorithm. Equal numbers of age, sex, donor type, human leukocyte antigen mismatch, and immunosuppression-matched patients were selected for comparison as the control group (Table 1). In the study group, daily C2 monitoring began on day 3 following transplantation and continued until day 7, at least once weekly during the first month,
Results
In the study group, the mean C2 during the first month was 1200 ng/mL (1205.75 ± 387.75 ng/mL), 950 ng/mL at 3 months (942.2 ± 287.5 ng/mL), 800 ng/mL at 6 months (817.2 ± 279.3 ng/mL), and 550 ng/mL at 12 months (558.5 ± 94.2 ng/mL). The mean calculated AUC0–4 was 6000 ng/mL/h during the first month (6079.5 ± 803 ng/mL/h), 5000 ng/mL/h at 3 months (4916 ± 126.5 ng/mL/h), 4400 ng/mL/h at 6 months (4326.7 ± 1164.4 ng/mL/h), and 3000 ng/mL/h at 12 months (3042.7 ± 959.3 ng/mL/h). C0 was higher in
Discussion
The aim of this investigation was to attain an adequate AUC for comparison with C0 and C2 values during the study period. C2 in this study was less than that noted in other studies by 27% to 32%, particularly when guided by our therapeutically adequate calculated AUC values. The C2 level was 95% more accurate as a single test predictor of CsA exposure when correlated with calculated AUC compared with <70% correlation for C0 with AUC. Further, C0 correlated with AUC was significantly less after
Acknowledgments
We are sincerely grateful to Mrs Mini Abraham for statistical analyses of our data.
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