Advantages of cyclosporin A using 2-h levels in pediatric kidney transplantation

Pediatric Nephrology : Journal of the International Pediatric Nephrology Association
L PapeG Offner

Abstract

Clinical trials in adult liver and heart recipients have shown that management of cyclosporine (CsA) dose with 2-h levels (C2) leads to lower rejection rates and serum creatinine levels compared with C0 monitoring. Therefore, we investigated whether C2 monitoring might also improve late graft survival after kidney transplantation in children. To date, no results in adult renal transplantation and in pediatric transplantation have been published. Forty-nine stable pediatric kidney recipients with a minimum time of 1 year after transplantation (mean=7+/-5 years) entered the study. None of the patients had experienced an acute rejection up to 6 months before entering the study. CsA dosing was based on C0 monitoring for the first 6 months and then based on C2 monitoring for the following 6 months. C0 and C2 levels were measured at 4-weekly intervals. Percentage decline in glomerular filtration rate (GFR) and mean coefficients of variation of CsA levels (C(var)) were calculated and compared during the 6-months periods. At the beginning of the study, the mean calculated GFR was 53+/-15 ml/min per 1.73 m(2). During the 6 months of C0 monitoring, the mean GFR decreased to 49+/-12 m/min per 1.73 m(2 )( P=0.001, paired t-test). Six month...Continue Reading

Citations

Sep 28, 2007·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Nicholas J A WebbJanice S Ellis
May 25, 2005·Pediatric Transplantation·P Rianthavorn, R B Ettenger
Jul 17, 2007·Pediatric Transplantation·S Paul HmielMichelle Nadler
May 13, 2015·Pediatric Transplantation·Madeleine S DidsburySean E Kennedy
May 30, 2006·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·S SchubertF Berger
Apr 9, 2005·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Guido Filler
May 26, 2007·Paediatric Drugs·Guido Filler
Apr 26, 2014·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Lutz T Weber

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