Nephro-Urology Monthly

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Change of Cyclosporine Absorption over the Time After Kidney Transplantation

Behzad Einollahi 1 , Mojtaba Teimoori 1 and Zohreh Rostami 1 , *
Authors Information
1 Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
Article information
  • Nephro-Urology Monthly: March 01, 2012, 4 (2); 470-474
  • Published Online: March 1, 2012
  • Article Type: Research Article
  • Received: September 27, 2011
  • Revised: October 6, 2011
  • Accepted: October 17, 2011
  • DOI: 10.5812/numonthly.2437

To Cite: Einollahi B, Teimoori M, Rostami Z. Change of Cyclosporine Absorption over the Time After Kidney Transplantation, Nephro-Urol Mon. 2012 ; 4(2):470-474. doi: 10.5812/numonthly.2437.

Copyright © 2012, Nephrology and Urology Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Objectives
3. Patients and Methods
4. Results
5. Discussion
  • 1. Rostami Z, Einollahi B. Cyclosporine monitoring in organ transplantation: Do we need a new concept? Nephro-Urol Mon. 2012; 3(2): 97-8
  • 2. Tha-In T, Hesselink DA, Tilanus HW, Elshove L, Wilschut AL, Hansen BE, et al. Clinical outcome after cyclosporine dose reduction based on C2 levels in long-term liver transplant patients. Clin Transplant. 2005; 19(4): 537-42[DOI][PubMed]
  • 3. Einecke G, Mai I, Fritsche L, Slowinski T, Waiser J, Neumayer HH, et al. The value of C2 monitoring in stable renal allograft recipients on maintenance immunosuppression. Nephrol Dial Transplant. 2004; 19(1): 215-22[DOI][PubMed]
  • 4. Nashan B, Cole E, Levy G, Thervet E. Clinical validation studies of Neoral C(2) monitoring: a review. Transplantation. 2002; 73(9 Suppl)-11[DOI][PubMed]
  • 5. Buchler M, Chadban S, Cole E, Midtvedt K, Thervet E, Prestele H, et al. Evolution of the absorption profile of cyclosporine A in renal transplant recipients: a longitudinal study of the de novo and maintenance phases. Nephrol Dial Transplant. 2006; 21(1): 197-202[DOI][PubMed]
  • 6. Einecke G, Mai I, Diekmann F, Fritsche L, Neumayer HH, Budde K. Cyclosporine absorption profiling and therapeutic drug monitoring using C(2) blood levels in stable renal allograft recipients. Transplant Proc. 2002; 34(5): 1738-9[DOI]
  • 7. Absorption profiling of cyclosporine microemulsion (neoral) during the first 2 weeks after renal transplantation. Transplantation. 2001; 72(6): 1024-32[DOI]
  • 8. Belitsky P, Dunn S, Johnston A, Levy G. Impact of absorption profiling on efficacy and safety of cyclosporin therapy in transplant recipients. Clin Pharmacokinet. 2000; 39(2): 117-25[DOI][PubMed]
  • 9. Cyclosporine microemulsion (Neoral) absorption profiling and sparse-sample predictors during the first 3 months after renal transplantation. Am J Transplant. 2002; 2(2): 148-56[DOI]
  • 10. Mahalati K, Belitsky P, West K, Kiberd B, Fraser A, Sketris I, et al. Approaching the therapeutic window for cyclosporine in kidney transplantation: a prospective study. J Am Soc Nephrol. 2001; 12(4): 828-33[PubMed]
  • 11. Randomized, international study of cyclosporine microemulsion absorption profiling in renal transplantation with basiliximab immunoprophylaxis. Am J Transplant. 2002; 2(2): 157-66[DOI]
  • 12. Sumethkul V, Tankee P, Chalermsanyakorn P, Jirasiritham S. long-term outcome of very early cyclosporine minimization and de novo everolimus therapy in kidney transplant recipients: a pharmacokinetic guided approach. Transplant Proc. 2010; 42(10): 4040-2[DOI][PubMed]
  • 13. Etienne I, Toupance O, Benichou J, Thierry A, Al Najjar A, Hurault de ligny B, et al. A 50% reduction in cyclosporine exposure in stable renal transplant recipients: renal function benefits. Nephrol Dial Transplant. 2010; 25(9): 3096-106[DOI][PubMed]
  • 14. Felipe CR, Silva HT, Jr., Machado PG, Garcia R, Moreira SR, Pestana Jo. Time-dependent changes in cyclosporine exposure: implications for achieving target concentrations. Transpl Int. 2003; 16(7): 494-503[DOI][PubMed]
  • 15. Waiser J, Slowinski T, Brinker-Paschke A, Budde K, Schreiber M, Bohler T, et al. Impact of the variability of cyclosporin A trough levels on long-term renal allograft function. Nephrol Dial Transplant. 2002; 17(7): 1310-7[DOI][PubMed]
  • 16. Grevel J, Post BK, Kahan BD. Michaelis-Menten kinetics determine cyclosporine steady-state concentrations: a population analysis in kidney transplant patients. Clin Pharmacol Ther. 1993; 53(6): 651-60[DOI][PubMed]
  • 17. Awni WM, Kasiske BL, Heim-Duthoy K, Rao KV. long-term cyclosporine pharmacokinetic changes in renal transplant recipients: effects of binding and metabolism. Clin Pharmacol Ther. 1989; 45(1): 41-8[DOI][PubMed]
  • 18. Gubbins PO, Bertch KE. Drug absorption in gastrointestinal disease and surgery. Clinical pharmacokinetic and therapeutic implications. Clin Pharmacokinet. 1991; 21(6): 431-47
  • 19. Lemahieu WP, Maes BD, Verbeke K, Vanrenterghem YF. Alterations of CYP3A4 and P-glycoprotein activity in vivo with time in renal graft recipients. Kidney Int. 2004; 66(1): 433-40[DOI][PubMed]
  • 20. Hebert MF. Contributions of hepatic and intestinal metabolism and P-glycoprotein to cyclosporine and tacrolimus oral drug delivery. Adv Drug Deliv Rev. 1997; 27(2-3): 201-14[DOI]
  • 21. Lampen A, Christians U, Bader A, Hackbarth I, Sewing KF. Drug interactions and interindividual variability of ciclosporin metabolism in the small intestine. Pharmacology. 1996; 52(3): 159-68[DOI][PubMed]
  • 22. Lown KS, Mayo RR, leichtman AB, Hsiao Hl, Turgeon DK, Schmiedlin-Ren P, et al. Role of intestinal P-glycoprotein (mdr1) in interpatient variation in the oral bioavailability of cyclosporine. Clin Pharmacol Ther. 1997; 62(3): 248-60[DOI]
  • 23. Brunner lJ, Bennett WM, Koop DR. Cyclosporine suppresses rat hepatic cytochrome P450 in a time-dependent manner. Kidney Int. 1998; 54(1): 216-23[DOI][PubMed]
  • 24. Amante AJ, Meier-Kriesche HU, Schoenberg l, Kahan BD. A pharmacokinetic comparison of the corn oil versus microemulsion gelcap formulation of cyclosporin used de novo after renal transplantation. Transpl Int. 1997; 10(3): 217-22[DOI][PubMed]
  • 25. Barone G, Chang CT, Choc MG, Jr., Klein JB, Marsh Cl, Meligeni JA, et al. The pharmacokinetics of a microemulsion formulation of cyclosporine in primary renal allograft recipients. The Neoral Study Group. Transplantation. 1996; 61(6): 875-80[DOI][PubMed]
  • 26. Kovarik JM, Mueller EA, Richard F, Niese D, Halloran PF, Jeffery J, et al. Evidence for earlier stabilization of cyclosporine pharmacokinetics in de novo renal transplant patients receiving a microemulsion formulation. Transplantation. 1996; 62(6): 759-63[DOI][PubMed]
  • 27. Cole E, Maham N, Cardella C, Cattran D, Fenton S, Hamel J, et al. Clinical benefits of neoral C2 monitoring in the long-term management of renal transplant recipients. Transplantation. 2003; 75(12): 2086-90[DOI][PubMed]
  • 28. Curtis JJ, lynn M, Jones PA. Neoral conversion from Sandimmune in maintenance renal transplant patients: an individualized approach. J Am Soc Nephrol. 1998; 9(7): 1293-300[PubMed]
  • 29. Khalkhali HR, Ghafari A, Hajizadeh E, Kazemnejad A. Risk factors of long-term graft loss in renal transplant recipients with chronic allograft dysfunction. Exp Clin Transplant. 2010; 8(4): 277-82[PubMed]
  • 30. Cheung CY, Chan HW, Chan Yh, Chau KF, li CS. Impact of delayed graft function on renal function and graft survival in deceased kidney transplantation. Hong Kong Med J. 2010; 16(5): 378-82[PubMed]
  • 31. Ekberg H, Tedesco-Silva H, Demirbas A, Vitko S, Nashan B, Gurkan A, et al. Reduced exposure to calcineurin inhibitors in renal transplantation. N Engl J Med. 2007; 357(25): 2562-75[DOI][PubMed]
  • 32. Sugiyama K, Isogai K, Toyama A, Satoh H, Saito K, Nakagawa Y, et al. Pharmacodynamic parameters of immunosuppressive drugs are not correlated with age, duration of dialysis, percentage of lymphocytes or lymphocyte stimulation index in renal transplant recipients. Biol Pharm Bull. 2008; 31(11): 2146[DOI][PubMed]
  • 33. Midtvedt K, Fauchald P, Bergan S, Hoieggen A, Hallan S, Svarstad E, et al. C2 monitoring in maintenance renal transplant recipients: is it worthwhile? Transplantation. 2003; 76(8): 1236-8[DOI][PubMed]
  • 34. Karim MS, Wood RF, Dawnay AB, Fulton PA. The effect of renal ischemia on cyclosporine clearance in rabbits. Transplantation. 1990; 49(3): 500-2[DOI][PubMed]
  • 35. Moyer TP, Johnson P, Faynor SM, Sterioff S. Cyclosporine: a review of drug monitoring problems and presentation of a simple, accurate liquid chromatographic procedure that solves these problems. Clin Biochem. 1986; 19(2): 83-9[DOI]
  • 36. Nakagawa T, Kang DH, Ohashi R, Suga S, Herrera-Acosta J, Rodriguez-Iturbe B, et al. Tubulointerstitial disease: role of ischemia and microvascular disease. Curr Opin Nephrol Hypertens. 2003; 12(3): 233-41[DOI][PubMed]
  • 37. Massy ZA, Kasiske Bl. Post-transplant hyperlipidemia: mechanisms and management. J Am Soc Nephrol. 1996; 7(7): 971-7[PubMed]
  • 38. Princen HM, Meijer P, Wolthers BG, Vonk RJ, Kuipers F. Cyclosporin A blocks bile acid synthesis in cultured hepatocytes by specific inhibition of chenodeoxycholic acid synthesis. Biochem J. 1991; 275: 501-5[PubMed]
  • 39. Markell MS, Armenti V, Danovitch G, Sumrani N. hyperlipidemia and glucose intolerance in the post-renal transplant patient. J Am Soc Nephrol. 1994; 4(8 Suppl)-47[PubMed]
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