Cyclosporine through and 2 hour post dose monitoring and its contributing factors among pediatric kidney recipients

Cyclosporine (CsA) is one of the most frequently used anti-rejection drugs in organ transplant. Pediatric patients have different CsA pharmacokinetics than adults. The aim of this retrospective study was to evaluate the CsA blood levels monitoring in pediatric renal transplant recipients in a single-center setting, after the first year of transplantation.Patients and We reviewed 236 pediatric kidney recipients (aged ≤ 18) years old who received a kidney for the first time with at least a minimum time of 1 year after transplantation between April 2008 and June 2010. Mean follow-up was at least 6 months. The male to female ratio was 1.3/1.0. Mean age of patients’ were 14 ± 3 years. A negative relation was found between CsA levels (C0 and C2) with serum creatinine (r = -0.1, P = 0.001 and r = -0.1, P = 0.01, respectively). A significant correlation was found between C0 level and liver enzymes. Although increase in the donor age had a negative effect on C0 as well as C2 levels, significant value was only shown in C2 level (r = -0.5, P = 0.1 vs. r = -0.15, P = 0.000). C0 level was higher in male than female gender (P = 0.000) as well as in deceased donor source (P = 0.000). Serum creatinine level, serum alkaline phosphatase, liver enzymes affected C0 blood level; whereas, donor age and serum creatinine were the confounding variables on C2 level. We conclude that C0 was affected by serum creatinine level, serum alkaline phosphates, liver enzymes; whereas, C2 level was influenced by donor age and serum creatinine.