Cyclosporine Monitoring and Pharmacokinetics in Pediatrie Liver Transplant Patients.

THE DEVELOPMENT of cyclosporine (CyA) as a novel immunosuppressive agent has dramatically advanced orthotopic liver transplantation (OLT). The use of CyA in pediatrie OLT patients has been hindered by a lack of information concerning the drug’s pharmacokinetics in children and the interpretation of blood concentrations during therapy. OLT should have a major effect on CyA’s absorption, distribution, metabolism, and excretion since CyA is fat-soluble, highly protein-bound, completely metabolized, and excreted in the bile.1 Presently, two methods are available for measuring CyA in biological fluids. The two drug assays available produce different results2 and measure different components of CyA activity. The primary objectives of this study were (1) to examine the bioavailability and pharmacokinetics of CyA in children receiving OLTs and (2) to examine the relationship between drug assay results and the biochemical and clinical status of the pediatrie OLT patients.