Optimizing cyclosporine use in pediatric patients by measuring pretransplant blood levels.

A method for measuring pretransplant CsA levels to predict posttransplant pharmacokinetic behavior was studied in a total of seven pediatric patients. Comparison of drug levels and single-dose pharmacokinetic characteristics in the pretransplant and posttransplant study periods suggest that this method (1) is useful in predicting early posttransplant blood levels and beta-phase half-life; (2) may prevent early episodes of acute allograft rejection associated with subtherapeutic cyclosporine immunosuppression; and (3) may identify those patients who should not be empirically treated with only cyclosporine and prednisone in the early posttransplant period.