Therapeutic drug monitoring of cyclosporine and tacrolimus in Myanmar kidney transplant patients

Abstract

IntroductionRenal transplantation is one of the best options for patients suffering from end stage renal disease (ESRD). Cyclosporine and Tacrolimus are mainly applied in immunosuppressive therapy after transplantation of liver, kidney, heart, and other organs. The used of immunosuppressant drugs improve the survival of transplanted organs and reduce organ rejection. Because of their narrow therapeutic index and significant inter-individual variability in blood concentrations, they need to monitor carefully. Therapeutic drug monitoring of tacrolimus and cyclosporine were needed to optimize the outcome in patients after renal transplantations. Maintaining the drugs levels reduce the risks of toxicity or rejection, respectively. ObjectiveThe aim of this study is to identify the optimum blood trough level for cyclosporine and tacrolimus in Myanmar kidney transplant recipients. Materials and methodA retrospective cross sectional design was used and data collected from 50 patients who underwent kidney transplantation and receiving either cyclosporine or tacrolimus within six months after kidney transplantation. Among them 15 and 35 patients are taking cyclosporine and tacrolimus, respectively. For cyclosporine or tacrolimus trough-level monitoring, whole blood sample was drawn 15 min before the next dose and measured by immunoassay method. ResultsThe results showed that majority of cyclosporine and tacrolimus whole blood levels based on C0 (before the dose) concentration were achieved the therapeutic range. ConclusionTherefore, drugs concentration and the recommended clinical conditions should be routinely monitored to adjust the treatment and reduce adverse reactions. Therapeutic drug monitoring of cyclosporine and Tacrolimus are important for the benefits of renal transplant patients in Myanmar.