García-Gallont R, Toledo Solares M
Transplantation Unit, Hospital General San Juan de Dios, Guatemala City, Guatemala.
Transplant Proc. 2004 Mar;36(2 Suppl):451S-453S. doi: 10.1016/j.transproceed.2004.01.068.
Optimal dosing of cyclosporine is difficult in transplant recipients. The introduction of the microemulsion Neoral in 1997 into our program and the measurement of C2 levels since 2000 in our center has allowed for more accurate individual dose finding. In our series, 141 transplant recipients (92 de novo, 49 maintenance) were followed for a 3-year period with C2 monitoring and serum creatinine levels as well as creatinine clearance studies. Biopsy proven acute rejection episodes appeared in three patients. The target levels of C2 during the first week were of vital importance to prevent acute rejection. Targets for the later periods of our study were somewhat lower than those recommended in North American or European studies. Even so, the incidence of acute rejection was low (3.2% for the de novo group). We feel that special populations like ours (mostly Mayan) deserve more attention regarding the finding of the optimal dose for immunosuppressive therapy after kidney transplantation.
在移植受者中确定环孢素的最佳剂量很困难。1997年我们的方案中引入了微乳剂新山地明（Neoral），并且自2000年起我们中心对C2水平进行监测，这使得能够更准确地确定个体剂量。在我们的研究系列中，141名移植受者（92名初次移植者，49名维持治疗者）接受了为期3年的C2监测、血清肌酐水平以及肌酐清除率研究。经活检证实有3名患者出现急性排斥反应。第一周的C2目标水平对于预防急性排斥至关重要。我们研究后期的目标略低于北美或欧洲研究中推荐的目标。即便如此，急性排斥的发生率仍较低（初次移植组为3.2%）。我们认为像我们这样的特殊人群（大多数为玛雅人）在肾移植后免疫抑制治疗最佳剂量的确定方面值得更多关注。
