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KMID : 0361120020160020198
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Korean Journal of Transplantation
2002 Volume.16 No. 2 p.198 ~ p.204
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Validity of C2 Monitoring of Microemulsion Cyclosporine in Early Renal Transplant Period
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이종훈*,§/Jong Hoon Lee*,§
김명수*,‡/권기환†/김봉수†/허규하†/김수현†/김혜진†/전경옥†/김현정†/김순일*,†/김유선*,†/박기일*,†/Myoung Soo Kim*,‡/Ki Hwan Kwon†/Bong Soo Kim†/Kyu Ha Huh†/Soo Hyon Kim†/Hae Jin Kim†/Kyung Ock Jeon†/Hyun Jung Kim†/Soon Il Kim*,†/Yu Seun
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Abstract
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Purpose: Four-hour area under the concentration-time curve (AUC0-4) was considered to be superior rather than C0 in predicting the development of acute rejection, and was reported most well correlated with
C2
in
post-transplant period. The purpose of this study was to demonstrate the correlation between AUC0-4 and each C0,1,2,3,4, and to compare C2 with C0 in predicting acute rejection in de-novo kidney
recipients.
Methods: Fifty-six adult living donor kidney transplants were followed up 3 months after transplantation. Cyclosporine A (CsA) dose was adjusted with C0. AUC0-4 was measured on 5th and 19th
post-operative day, and C2 as well as C0 was measured on post-operative 5, 12, 19, 30, 60, 90 days.
Results: Fifteen patients (26.8%) experienced acute rejection 12.0±10.9 (5∼48) days after transplantation. CsA absorption pharmacokinetics was different with data based on Caucasian recipients. In more than 60% of patients, peak
concentration
(Cmax) was reached 2 hours after oral intake of CsA regardless the occurrence of acute rejection and postoperative days. AUC0-4 was most critically correlated with C2 on 5th and 19th
post-operative
days (R2＞0.800, respectively). Recipients having acute rejection between 5th and 7th post-operative day, had statistically lowered AUC0-4, C2, C3 (P＜0.05) compared with patients
without
acute rejection.
Conclusion: In early post-transplant days, AUC0-4 was powerfully correlated with C2. Monitoring of C2 rather than C0 could predict the occurrence of acute rejection in this period. Value of
C2 monitoring in Koreans beyond 7th day awaits further study by adjusting CsA dose with C2 rather than C0.
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