Suitable Calcineurin Inhibitor Concentrations for Liver Transplant Recipients in the Chinese Population

• Published in: Transplantation proceedings Vol. 43; no. 5; pp. 1751 - 1753
• Main Authors: Chen, Y.B, Li, S.D, Ju, B.L, Shi, X.J, Lu, F, Hu, D.K, Yu, C.H, Dong, J.H
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Inc 01-06-2011; Elsevier
• Subjects: Adult; Biological and medical sciences; Calcineurin Inhibitors; China; Cyclosporine - administration & dosage; Cyclosporine - blood; Drug Monitoring; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Immunosuppressive Agents - administration & dosage; Immunosuppressive Agents - blood; Liver Transplantation; Male; Medical sciences; Middle Aged; Retrospective Studies; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tacrolimus - administration & dosage; Tacrolimus - blood; Tissue, organ and graft immunology; Asia; China; Human; Medicine; Calcineurin inhibitor; Treatment; Digestive system; Surgery; Liver; Graft; Transplantation; Concentration; Homotransplantation
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2010.11.025

Abstract Aim The aim was to deduce suitable calcineurin inhibitor concentrations for the Chinese liver transplantation population. Methods We retrospectively studied 97 liver transplant recipients who displayed stable liver and renal function. No grafts were obtained from prisoners, procurements were performed with donor consent conforming to international ethics regulations. At 3, 6, and 12 months, we increased the concentrations and doses of calcineurin inhibitors as well as the values of alanine transaminase and serum creatinine. Results Twenty-eight recipients received cyclosporine and 69 tacrolimus. The mean cyclosporine daily dosages were 203 ± 62 mg at 3, 188 ± 55 mg at 6, and 173 ± 52 mg at 12 months, the tacrolimus daily dosages were 3.08 ± 0.98, 2.82 ± 0.98, and 2.58 ± 0.93 mg, respectively. The corresponding mean cyclosporine peak concentrations (C2 ) were 806 ± 322 ng/mL, 681 ± 206 ng/mL, and 644 ± 190 ng/mL and the mean tacrolimus trought concentrations (C0 ) 6.61 ± 3.02 ng/mL, 5.85 ± 2.44 ng/mL, and 5.22 ± 2.33 ng/mL, respectively. In both groups, transaminases and serum creatinine were stable over time. Conclusions An individualized immunosuppressive regimen for the local population is necessary. We delayed calcineurin inhibitors with subsequent low-dose mycophenolate mofetil plus minimized calcineurin inhibitors, which seemed to be nephropreotective and safe for Chinese liver transplantation patients.