Cyclosporine Through and 2 Hour Post Dose Monitoring and Its Contributing Factors among Pediatric Kidney Recipients

Background: Cyclosporine (CsA) is one of the most frequently used anti-rejection drugs in organ transplant. Pediatric patients have different CsA pharmacokinetics than adults. Objectives: 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 Methods: 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. Results: 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. Conclusions: 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.