[Blood level oriented ambulatory cyclosporin A therapy following kidney transplantation]

It is reported on the blood level-oriented oral long-term therapy with cyclosporin-A (Sandimmun) in 20 patients after kidney transplantation. The Cy-A-concentrations were measured in the whole blood by means of a radioimmunoassay (Sandoz) under steady state conditions. The mathematical analysis of the steady state daily minimum concentrations in the whole blood depending upon the dosage rate allows individual calculations of the dosage for the stabilisation of the therapeutic concentration desirable for the individual patient in each case. In the majority of the patients a non-linear relation between the steady state blood concentration and the dosage rate was present. The observation of a defined therapeutic area under the conditions of the ambulatory treatment could be achieved without any problems. The control intervals were 4-6 weeks. The long-term stability of the individual pharmacokinetic parameters can at present not be judged reliably, since the average observation time is still too short. In 6 patients who are controlled on the way demonstrated already for several months no systemic changes in the behaviour of the blood level were to be seen.