A PROPOSAL OF FK506 OPTIMAL DOSING IN LIVING-RELATED LIVER TRANSPLANTATIONS

Citation
M. Ueda et al., A PROPOSAL OF FK506 OPTIMAL DOSING IN LIVING-RELATED LIVER TRANSPLANTATIONS, Transplantation, 60(3), 1995, pp. 258-264
Citations number
38
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Immunology,Surgery,Transplantation
Journal title
ISSN journal
0041-1337
Volume
60
Issue
3
Year of publication
1995
Pages
258 - 264
Database
ISI
SICI code
0041-1337(1995)60:3<258:APOFOD>2.0.ZU;2-H
Abstract
We analyzed the relation between FK506 trough levels (ELISA: patients 1-41, IMx: patients 42-70) and rejection and/or viral infection episod es, retrospectively, in the first 70 consecutive cases of living relat ed liver transplantation. Twenty patients (28.6%) had rejection episod es. Of the 13 patients who had evidence of rejection during the first 3 months, 6 patients without infection and 7 patients with viral infec tion showed low concentrations of FK506 (<5 ng/ml), Twelve patients we re treated and improved with high dose steroid administration and an i ncrease in the FK506 dosage. One patient died of refractory rejection. Nine patients had evidence of rejection after the first 3 months, In 3 patients, weaning from FK506 initiated the rejection episodes, Five patients repeated rejection and 4 patients required a third immunosupp ressant (azathioprine). Viral infection included CMV (11 cases), EBV ( 13 cases), HZV (3 cases), and HSV (1 case). Excess immunosuppression m ight have been the cause, but no clear correlation was found. We propo se that the optimal dosage of FK506 obtained by monitoring the trough levels using the IMx method should maintain a 10-20 ng/ml level during the first month, and a 5-10 ng/ml level at the second and third month s.