Abstract

THERAPEUTIC MONITORING OF CYCLOSPORINE-A IN IRAQI PATIENTS KIDNEY TRANSPLANTED

Hassan Mohamed Al-Temimi Mowafaq Mohammed Ghareeb, Ali Abdulmajid Dyab, Kawther Faris Al-Temimi*

ABSTRACT

Cyclosporine A (CSA) is selective immunosuppressant widely used in kidney transplant, this study was designed to monitor the drug plasma concentration and evaluation its safety and efficacy in Iraqi centre of Therapeutic drug monitoring. The blood samples were analyzed for the concentration of CSA by using AXSYM automated florescence polarization immunoanalyzer. Clinical parameters concerning CSA concentrations with its safety were measured for 60 patients receiving 5mg/Kg/day orally in two divided dose every 12hr after kidney transplant. The measured area under the concentration-time curve (AUC) describes total drug exposure during the entire dosing interval (0-12 hr).There are a significant elevation (P<0.05) in the levels of systolic blood pressure, diastolic blood pressure, serum creatinine, blood urea, uric acid, total cholesterol (TC), triglyceride (TG), AST, ALT, bilirubin, K, and Ca levels equal to 15.7, 14.5, 35.5, 41 , 57.6 , 42.3, 29.5, 42.6, 57, 59, 48.8, and 35.7% respectively after the dose compared with baseline value, on the other hand a significant reduction (P<0.05) of Mg and phosphate level equal to 52 and 40% respectively were observed. It can be concluded that the monitoring of CSA is very important to determine the therapeutic and toxic concentration of oral CSA. The more effective prevention of kidney rejection after transplant could be achieved by careful monitoring of CSA concentrations. There is a good relation between the efficacy, safety of the CSA and its dose, the severity of adverse effects is dose dependent so the adjustment of dose is very important.

Keywords: cyclosporine A, kidney transplant, clinical parameters, TDM.