Abstract
Optimal dosing of cyclosporine is difficult in transplant recipients. The introduction of the microemulsion Neoral in 1997 into our program and the measurement of C 2 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 C 2 monitoring and serum creatinine levels as well as creatinine clearance studies. Biopsy proven acute rejection episodes appeared in three patients. The target levels of C 2 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.
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