使用Cyclosporine不同的監測方法（C2與C0）應用於孩童肝臟移植的研究

• Main Author: 胡秀蓉
• Other Authors: 詹道明
• Format: Others
• Language: zh-TW
• Published: 2003
• Online Access: http://ndltd.ncl.edu.tw/handle/nrzp27

碩士 === 高雄醫學大學 === 藥學研究所 === 91 === 英文摘要( Abstract ) Keywords: pediatric liver transplantation, cyclosporine, acute rejection Background. A retrospective study was conducted at a medical hospital in the southern Taiwan, involving 30 de novo pediatric liver transplant patients to compare the clinical usefulness of monitoring 2-hr post-dose cyclosporine levels (C2) (n = 15) with conventional trough cyclosporine blood levels (trough, pre-dose) (C0) (n = 15). Methods. Neoral oral therapy was initiated at 300 mg/m2/dose and dose adjusted according to predetermined C2 or C0 target level ranges. The efficacy evaluation variable was based on a composite endpoint of biopsy-proven rejection, renal function, liver function, dosage, adverse effects, infection, during the first 3 months after operation from the study. Results. Baseline characteristics were similar, except the mean age at operation. Overall incidence of acute rejection was not significantly different between the two groups (P > 0.05) . For biopsy-proven acute rejections, the incidence of moderate histological diagnosis was lower in the C2 group than in the C0 group. C2 patients who reached minimum target cyclosporine levels by day 3, the rejection rate was zero for the first 3 months, whereas there was no difference in the incidence of rejection in C0 patients, irrespective of time to reach target levels. The renal function, liver function (except in the 12 week data because C2 group the incidences of hepatic artery, venous thrombosis, cholangitis were large than C0 group) (7 in C2 and 4 in C0) and adverse effects were no difference between the two groups. The dose of cyclosporine was significantly different in the both groups on the day 7 (P < 0.05) and day 30 (P < 0.05) . On the day 7, the mean dose of C2 group (39.55 mg/ kg/day) was significantly higher than that in the C0 group (29.39 mg/kg/day) . In the contrast, on the day 30 the average dose of C2 group (12.9 mg/kg/day) was significantly lower in the C0 group (17.38 mg/kg/day). Conclusion. There was no significant different between C2 and C0 about the overall incidence of acute rejection and the histological severity of acute rejection. Although the dose was higher in C2 group within first week after operation, there was no difference about renal function and safety profile between the 2 groups.