Interet de la determination simultanee des taux sanguins de ciclosporine par methodes specifique et non specifique chez le transplante hepatique. [Value of simultaneous determination of cyclosporin blood levels using specific and nonspecific methods in liver transplantation]
Details
Serval ID
serval:BIB_6764D98374B6
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Interet de la determination simultanee des taux sanguins de ciclosporine par methodes specifique et non specifique chez le transplante hepatique. [Value of simultaneous determination of cyclosporin blood levels using specific and nonspecific methods in liver transplantation]
Journal
Schweizerische Medizinische Wochenschrift
ISSN
0036-7672 (Print)
Publication state
Published
Issued date
04/1992
Volume
122
Number
17
Pages
655-8
Notes
English Abstract
Journal Article --- Old month value: Apr 25
Journal Article --- Old month value: Apr 25
Abstract
Cyclosporine's narrow therapeutic window and the large inter- and intra-individual variation of its pharmacokinetics require therapeutic monitoring. Cyclosporine is metabolized in the liver and excreted with its metabolite into the bile. An accumulation of metabolites occurs in liver dysfunction, leading to a high cyclosporine blood concentration when measured by a non-specific method (polyclonal antibodies). Specific methods (HPCL, monoclonal antibody) are therefore recommended by some authors. We evaluated the potential usefulness of simultaneous cyclosporine determination by a non-specific (fluorescent polarisation TDx, polyclonal antibodies) and a specific method (I125-RIA, monoclonal antibody). 10 patients were followed from 51 days to 32 months after hepatic transplantation. 2 patients who showed no graft rejection presented a polyclonal antibodies/monoclonal antibody ratio below or equal to 4 throughout their evolution. Other patients presented a rise of this ratio during periods of liver dysfunction, particularly in acute graft rejection. When bilirubin concentrations are plotted versus this ratio, an hysteresis is present during periods of acute rejection, but not during an episode of histological hepatitis. The same holds true for alkaline phosphatase and gamma-GT. These data suggest that this ratio could be a sensitive test for early detection of rejection. Simultaneous cyclosporine blood determination with specific and nonspecific methods may be useful in the follow-up of liver-transplanted patients.
Keywords
Adult
Cyclosporine/*blood/pharmacokinetics/therapeutic use
Female
Graft Rejection
Humans
Immunologic Techniques
Liver/metabolism
*Liver Transplantation
Male
Middle Aged
Radioimmunodetection
Sensitivity and Specificity
Pubmed
Web of science
Create date
25/01/2008 10:41
Last modification date
20/08/2019 14:22