مونيتورينگ سيكلوسپورين A در گيرندگان پيوند كليه بمنظور تنظيم غلظت دارو و تعيين محدوده هاي درماني

Monitoring of cyclosporine blood level to determine the therapeutic windows in kidney transplant recipients.

Introduction: Cyclosporine- A (CSA) is still regarded as a common Immunosuppressive agent in organ transplantation. CSA induced in effects by inhibition approach to reduce the risk of graft rejection and to prevent the toxicity effects. Methods: In this investigation, CSA level in the blood (peak level and Trough level) was monitored in 38 kidney recipients during 1 months after transplantation. Haematological- biochemical parameters, drug interaction and clinical manifestations were observed during this period. Results revealed that the CSA clearance in our patients is maximized in patients under 32 years old contray to those reports from Europan centers which emphasize on patients under 45 years old. Results:CSA peak and Trough level increased significantly in patients. In contrast, CSA dose, cystolic and diastolic blood pressures significantly reduced. This finding further suggests that a safe and efficient dose for CSA in our patients is (3.02-5.82) mg/kg with a therapeutic windows for peak and Trough level of (520-1446) and (197-492) ng/ml respectively (CSA and metabolites). DJSCUSsion:ln cases which only the parents, CSA (without its metabolites) was measured, the therapeutic windows for Trough level was (81-301)ng/ml. The finding indicate compared with the higher dose and CSA peak and Trough level already recommended in western and European transplant centers.