Pharmacokinetic strategies for cyclosporin therapy in organ transplantation Academic Article Article uri icon

Overview

MeSH Major

  • Ambulatory Surgical Procedures
  • Anesthesia
  • Neoplasms

abstract

  • Marked interindividual variations in cyclosporin (CsA) produce disparate clinical results in organ transplant recipients. In an attempt to eliminate marked deviations of insufficient or excessive CsA concentrations consequent to the administration of uniform drug doses, test dose pharmacokinetics were performed on each potential organ transplant candidate. An intravenous 3 mg/kg test dose delivered over 3 h proved to be readily performed, namely 53% perfect studies, and relatively reliable, namely 73% of observed concentrations within 10% of the predicted values. Furthermore, the use of CsA doses predicted by pretransplant studies reduces the incidence of delayed graft function, early rejection episodes and transplant loss. The oral test dose study predicted a suitable amount of CsA to achieve sufficient gastrointestinal absorption but was less accurate than the iv prediction method: namely, 40% of observed post-transplant concentrations were within 10% of the predicted target value. Furthermore, patients who received oral doses predicted by the test dose strategy showed no improvement in the incidence of acute rejection episodes between 7 and 60 days, and only modestly improved serum creatinine values. The lower accuracy of predictions from oral test dose studies may reflect the impact of non-linear oral (as opposed to iv) drug pharmacokinetics, of variable diet, and/or of altered postoperative gastrointestinal function.

publication date

  • January 1992

Research

keywords

  • Academic Article

Identity

Digital Object Identifier (DOI)

  • 10.1016/0896-8411(92)90051-Q

PubMed ID

  • 1503629

Additional Document Info

start page

  • 333

end page

  • 41

volume

  • 5

number

  • SUPPL. A