Monitoring the peak value of ciclosporin A blood drug level in patients after liver transplantation

Background: Reasonable application of immunosuppressive ciclosporin A (CsA) following liver transplantation depends on valley value of blood drug level during dynamic monitoring treatment. Present studies have shown that the blood drug level at 2 hours following administration (peak value) is the most sensitive point, which has clinical significants compared with ciclosporin. Objective: To investigate the range of peak concentration of CsA in patients following liver transplantation. Design, Time and Setting: The retrospective case analysis was performed at the Department of Hepatobiliary Surgery, First Affiliated Hospital, Medical College, Xi'an Jiaotong University from November 2000 to November 2003. Participants: A total of 49 patients underwent liver transplantation. Methdos: Following oral administration of CsA, blood drug level was monitored. At 2 hours following administration, the peak value of blood drug level was measured. Of 49 patients, 157 samples were tested in 2 years. Peak value level could be detected every week in early transplantation phase once. Peak value level was measured in male patients 121 times, and in female patients 36 times for statistical analysis. Main Outcome Measures: Blood drug level at 2 hours following CsA treatment; the range of blood drug level of CsA peak value. Results: Immunosuppressant was used following liver transplantation. The ideal range of blood drug level peak at 2 hours following CsA treatment: (923.11±259.99) μ g/L at 1 month, (1 024.53±253.56) μ g/L at 2 months, (1 030.54±268.02) μ g/L at 3 months, (661.50±242.66) μ g/L from 3 to 6 months, (674.38.±188.54) μ g/L from 6 to 12 months, (402.77±29.46) μ g/L from 1 to 2 years. The 49 patients were well. Conclusion: Immunosuppressant effects are satisfactory at 2 hours following CsA treatment in patients undergoing liver transplantation. This can be a reference for blood drug level range of CsA peak value in liver transplantation recipients.