Morris Raymond G, Ilett Kenneth F, Tett Susan E, Ray John E, Fullinfaw Robert O, Cooke Russell, Cook Stephen
Department of Cardiology and Clinical Pharmacology, The Queen Elizabeth Hospital, Woodville, South Australia, Australia.
Ther Drug Monit. 2002 Dec;24(6):677-88. doi: 10.1097/00007691-200212000-00001.
Therapeutic drug monitoring of cyclosporin (CsA) has been established as part of the routine clinical treatment of patients following organ transplantation for more than 20 years, and based on contemporary knowledge, many consensus guidelines have been published to assist clinics and laboratories attain optimal strategies for patient care. This article addresses the newer directions in CsA monitoring, with particular reference to the Australasian situation that has evolved since the 1993 Australasian guideline. These changes have included the introduction of alternative assay methodologies, changed CsA formulation from Sandimmun to Neoral throughout Australasia, and alternatives to trough concentration (C0) monitoring, especially 2-hour concentration (C2) monitoring and associated validated dilution protocols to accurately quantitate the higher whole blood CsA concentrations. The revision was prepared following a recent survey of all Australasian CsA-monitoring laboratories where discordant practices were evident.
环孢素（CsA）的治疗药物监测已成为器官移植患者常规临床治疗的一部分，至今已有20多年。基于当代知识，已发布了许多共识指南，以协助诊所和实验室制定最佳患者护理策略。本文探讨了CsA监测的新方向，特别参考了自1993年澳大利亚指南发布以来澳大利亚和新西兰地区的情况。这些变化包括引入替代检测方法，在整个澳大利亚和新西兰地区将CsA制剂从山地明改为新山地明，以及替代谷浓度（C0）监测的方法，特别是2小时浓度（C2）监测和相关的经过验证的稀释方案，以准确量化较高的全血CsA浓度。此次修订是在最近对所有澳大利亚和新西兰CsA监测实验室进行的一项调查之后进行的，调查发现存在明显不一致的做法。
