During the first postoperative months, exposure to MPA is low in a considerable proportion of liver transplant patients receiving MMF at a fixed dose of 1 g bid. MPA monitoring appears necessary in these patients.
Background: Graft survival depends on adequate immunosuppression. To evaluate the effect on the immune system of immunosuppressive therapies using calcineurin inhibitors (CNIs), several pharmacodynamic indices have been proposed to complement pharmacokinetic data. In this preliminary study we compared some of these parameters during combined immunosuppressant therapies. Methods: We treated 65 stable renal transplant recipients with cyclosporin A (CsA; n ؍ 16), tacrolimus (TRL; n ؍ 10); CsA ؉ mycophenolate mofetil (MMF; n ؍ 14); TRL ؉ MMF (n ؍ 13), and MMF (n ؍ 12). Twelve nontreated healthy controls were also included. Calcineurin activity (CNA) in peripheral blood mononuclear cells was measured using 32 P-labeled peptide. Interleukin-2 (IL-2) and interferon-␥ production in phytohemagglutinin-activated whole blood were measured at 0 and 2 h postdose. The areas under the curves, c min , c max , and concentration at 2 h (c 2 h ) were also measured.
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