Routine ureteric stenting is unnecessary in kidney transplantation in patients at low risk for urological complications. Careful surgical technique with selective stenting of problematic anastomoses yields similar results.

No abstract

No abstract

C0 correlates poorly with AUC based on PK0-4. Early AUC based on PK0-4 is more closely associated with AR and CsANT than is C0. Our data suggest that a target AUC0-12 of 9500-11500 or AUC0-4 of 4400-5500 microg x h/L may provide optimal Neoral immunosuppression.

This study used receiver operating characteristic analysis to investigate the properties of area under the concentration-time curve during the first 4 h after cyclosporin-microemulsion dosing (AUC 0ª4 ) and cyclosporin (CyA) levels immediately before and at 2 and 3 h after dosing (C 0, C 2 and C 3 ) to predict the risk of biopsy-proven acute rejection (AR) at 6 months. Ninety-eight kidney transplant recipients treated with CyA-microemulsion-based triple therapy immunosuppression were studied on post-transplant days 3, 5, and 7, and at increasing intervals thereafter. The most sensitive and specific predictor of AR was AUC 0ª4 . Of the single time-point measurements, the measurement properties of C 2 were closest to those of AUC 0ª4 , and superior to those of C 3 . The relationship between C 0 and subsequent AR was weak and did not reach statistical significance. On day 3, CyA AUC 0ª4 Ն 4400 ng . h/mL and C 2 Ն 1700 ng/mL were each associated with a 92% negative predictive value for rejection in the first 6 months. Pharmacokinetic measurements on or after day 5, and measurements on day 3 in patients with delayed graft function, were not predictive of AR. Adequate exposure within the first 3 days post transplantation may be critically important in preventing subsequent rejection.