Neoral use in the liver transplant recipient

This review and critical analysis of current trends of immunosuppression management in liver transplantation provides evidence and support for the continued role of Neoral as an indispensable part of immunosuppressive protocols. CyA formulation influences clinical outcomes such as acute rejection; this is confirmed by several multicenter studies. The CyA microemulsion formulation provides more reliable and effective absorption characteristics, and it may provide more rapid and complete immunosuppression in the de novo patient than IV administration. An advanced TDM strategy, particularly a 2-hour post-dose blood level (C-2), can improve the effectiveness and safety of immunosuppression in de novo liver transplant patients. There are potential risks resulting from CyA withdrawal strategies, as there is no evidence supporting this strategy. Neoral is an indispensable part of combination protocols in liver transplantation.