Two-hour post-dose cyclosporine monitoring does not fit all in kidney transplantation

Background: In transplant patients given cyclosporine (CsA), 2-hour post-dose sampling (C2) has been proposed as the most accurate single-sample surrogate marker for the area under the time–concentration profile (AUC). Further optimization of this CsA monitoring is however, required. Objectives: The study, designed in 58 stable adult kidney transplant recipients more than 1 year post-surgery, was aimed at defining the single-point sampling strategy that best predicts CsA AUC0–12, evaluating the precision of these strategies in AUC prediction according to different CsA absorption profiles, and establishing the predictivity of CsA pharmacokinetic parameters on graft outcome. Results: Regression analysis showed that C2 values (r = 0.902) best correlated with AUC0–12, whereas a lower correlation coefficient was found for C0 (r = 0.769). However, a large error in AUC prediction was documented even with the C2 equation model, with 33% of the estimations being unacceptable. Although C2 is considered a useful sur...