Cyclosporine absorption in kidney transplant recipients

Rostami et al. (1), had described the lack of accurate and reliable methods of cyclosporine (CYA) assays in their editorial. Although CYA level at 2 hours post-dose (C2) is the best way to predict area under the curve in kidney recipients and it correlates with acute allograft rejections and nephrotoxicity better than trough level (C0), we should keep in mind that optimized drug level early after transplantation is still a problem for most organ transplant patients (2). We agree with Rostami et al. (1) that we need a reliable way of monitoring CYA therapy since the adequate blood level of CYA is required to avoidance of the acute rejection and nephrotoxicity, but C2 blood level is not also an ideal marker for CYA assay, so we would like to discuss about CYA absorption which should be concerned