Three-years experience with Neoral C2 monitoring adjusted to a target range of 500–600 ng/ml in long-term renal transplant recipients receiving dual immunosuppressive therapy

Objective. There is little knowledge about the optimal 2-h post-dose concentration (C2 level) of cyclosporin A (CsA) in renal transplant recipients beyond 1 year post-transplant. The aim of this study was to investigate the effects of C2-CsA monitoring on Neoral® dose, renal graft function and systemic blood pressure in long-term renal transplant recipients, who had previously been monitored by means of trough levels (C0). Material and methods. Eighty-six patients treated with CsA+prednisolone were reviewed retrospectively during a follow-up period after switching to C2-CsA monitoring. Results. The patients were 6.0 years (3.4, 9.0 years) [median (25% quartile, 75% quartile)] post-transplant at the time of conversion to C2-CsA monitoring. They were studied for 3.7 years (3.3, 3.8 years). Baseline C0-CsA level was 161 ng/ml (131, 208 ng/ml). The Neoral dose was reduced in 95% of the recipients. The median C2 level was reduced by 40% to 585 ng/ml (484, 670 ng/ml) and, accordingly, the Neoral dose was reduce...