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Cyclosporine: progress, problems, and perspectives.

C T Van Buren

    The Surgical Clinics of North America
    |June 1, 1986
    PubMed
    Summary
    This summary is machine-generated.

    Cyclosporine is a key immunosuppressant in organ transplantation, particularly for high-risk kidney and extrarenal grafts. Monitoring drug levels ensures efficacy while minimizing toxicity during induction therapy.

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    Area of Science:

    • Immunology
    • Pharmacology
    • Transplantation Medicine

    Background:

    • Cyclosporine has become a cornerstone in organ transplantation.
    • It is the preferred immunosuppressive agent for high-risk renal and extrarenal organ recipients.

    Purpose of the Study:

    • To review the established role of cyclosporine in organ transplantation.
    • To discuss monitoring strategies and the balance between therapeutic efficacy and toxicity.
    • To consider future applications and challenges, including in highly sensitized patients.

    Main Methods:

    • Review of current clinical practices and literature regarding cyclosporine use.
    • Discussion of monitoring techniques like High-Performance Liquid Chromatography (HPLC) and Radioimmunoassay (RIA).
    • Analysis of the therapeutic window and toxicity profile of cyclosporine.

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    Main Results:

    • Cyclosporine demonstrates a favorable balance of immunosuppressive efficacy over toxicity in most patients.
    • HPLC and RIA assays are commonly used to optimize dosing during induction therapy.
    • The drug is widely accepted for high-risk transplant recipients.

    Conclusions:

    • Cyclosporine plays a significant role in current organ transplantation protocols.
    • Therapeutic drug monitoring is crucial for maximizing benefits and minimizing adverse effects.
    • Long-term outcomes and use in specific patient populations like the highly sensitized remain areas for future investigation.