Cyclosporin C₂-Monitoring zur Optimierung der Immunsuppression nach Nierentransplantation - Empfehlungen anhand Erster Erfahrungen in Deutschland

Cyclosporine has been worldwide the mainstay of immunosuppressive therapy in organ transplant recipients for prevention of acute and chronic rejection in the past two decades. The dosage is usually adjusted on the basis of whole blood through level (C₀ level) monitoring. However, it became evident after the development of the microemulsion formulation that a better correlation of the drug level taken two hours after medication (C₂ level) reflects the improved bioavailability of Cyclosporine much better. Interpatient variability in absorption as well as improved identification of over- or underdosing offer the opportunity of an individualized monitoring in order to improve drug exposure. C₂ levels published in the international literature mainly represent North-American clinical experience and practice with traditionally higher cyclosporine dosing in comparison to Europe. Since C₂-Monitoring has been introduced in german centers since last year, there was anonymous agreement for a consensus meeting to discuss recommendations for cyclosporine monitoring, better reflecting the German practice. The presented consensus focuses on immunosuppression in renal transplantation.