Experience with conversion from Sandimmun to Neoral cyclosporine and the correlation of C2 levels with renal function.

Pharmacologic monitoring of the cyclosporine microemulsion Neoral is an important tool to improve the efficacy and to avoid toxicity of the drug. Recent trials have shown that the absorption profiling tools represented by the area under the time-concentration curve from 0 to 4 hours postdose and concentration 2 hours postdose (C2) levels are the best predictors of acute rejection in the early posttransplant period. Since similar data regarding maintenance immunosuppression are scarce, we report our experience on Neoral C2 monitoring in renal transplant recipients during the late posttransplant period. However, available data on optimal Neoral C2 levels in the late posttransplantation period are scant and have not been correlated with well-defined endpoints such as chronic allograft nephropathy.