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Longitudinal evaluation of mycophenolic acid pharmacokinetics in pediatric kidney transplant recipients. The role of post-transplant clinical and therapeutic variables
- Publication Year :
- 2009
- Publisher :
- Blackwell Munksgaard:PO Box 2148, Periodicals Department, DK-1016 Copenhagen K Denmark:011 45 33 755913, EMAIL: agentservices@oxon.blackwellpublishing.com, INTERNET: http://www.blackwellmunksgaard.com, Fax: 011 45 77 333377, 2009.
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Abstract
- This longitudinal study assessed the influence of post-transplant clinical and therapeutic variables in 50 kidney transplant recipients aged 2-19 yr receiving a triple immunosuppressive regimen consisting of cyclosporine microemulsion (CsA), steroids and MMF (300-400 mg/m(2) body surface area twice daily), the full pharmacokinetic profile (10 points) of which was investigated on post-transplant days 6, 30, 180 and 360. Total plasma MPA was measured by Enzyme Multiplied Immunoassay Technique. CsA therapeutic drug monitoring (TDM) was performed via C2 blood monitoring, while MPA TDM via C0. MPA Cmax, tmax, AUC0-12 and AUC0-4 pharmacokinetic profile changed significantly during the first post-transplant year. C0 was a poor predictor of the total MPA exposure [as measured by the area under the concentration-time curve AUC)], while a truncated AUC was a good surrogate of the 12-h profile (r = 0.91; p < 0.001) Graft function and cyclosporine therapy influenced MPA pharmacokinetics, as shown by the univariate and multivariate analyses. We conclude that because after transplantation MPA exposure varied over time, a strict TDM is advisable in the pediatric population.
- Subjects :
- Adult
Male
Humans
Kidney Transplantation
Multicenter Study
Longitudinal Study
Cyclosporine
Steroids
MMF
medicine.medical_specialty
Adolescent
Cmax
Urology
Enzyme-Linked Immunosorbent Assay
Mycophenolic acid
Young Adult
Pharmacokinetics
Adrenal Cortex Hormones
medicine
Tissue Distribution
Longitudinal Studies
Postoperative Period
Child
Kidney transplantation
Enzyme multiplied immunoassay technique
Body surface area
Transplantation
Antibiotics, Antineoplastic
medicine.diagnostic_test
business.industry
Mycophenolic Acid
medicine.disease
Surgery
Therapeutic drug monitoring
Area Under Curve
Child, Preschool
Female
business
Immunosuppressive Agents
medicine.drug
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....a9f6278370f60d6173840537d2445297