Analysis of blood concentration monitoring result for cyclosporin a in renal transplant recipients surviving for more than three years / 中国药学杂志

ABSTRACT

OBJECTIVE: To analyze the results of blood concentration monitoring for cyclosporin A (CsA) in renal transplant recipients who have survived for more than three years, thus to investigate the relationship between CsA dose, blood concentration interindividual variability and gender and age, and to determine the possibility of decrease CsA dose and blood concentration by new triple therapeutic protocol, and to analyses the relationship between postoperation time and ρ2 and ρ0. METHODS: The blood concentrations of CsA of 97 patients (1 780 cases) were determined by FPIA method. The relationships between time after surgery, gender, age, immunosuppressive strategy and blood concentration of CsA were analyzed. RESULTS: The blood concentration and dose of CsA decreased with time after surgery, with significant inter-individual difference. The doses for female patients were larger than those for males in the early days after surgery, and then became smaller than male in later time, with no statistical significant difference. Under similar doses, the blood concentrations of CsA in females were lower than those in males, but with no significant difference. Twentyfour months after transplantation, significant difference of blood concentration was revealed between female and male patients (P < 0.05). With increasing age, the dose and blood concentration decreased in the two groups. The dose and blood concentration of CsA in patients elder than fifty years were lower than those in patients younger than fifty years in the same period after surgery. Compared with the old triple therapeutic protocol group, the dose of CsA and blood concentration decreased in the new triple therapeutic protocol group with significant difference. The ρ2 and ρ0 decreased following the time after operation with reduction of CsA dose. CONCLUSION: Significant individual difference exists in the dose and blood concentration of CsA in patients after renal transplantation. Multianalysis of the clinical feature of patients should be performed to adjust the therapeutic protocols, thus to achieve personalized pharmacotherapy and the best treatment results.