Cyclosporine (CsA) has a narrow therapeutic serum level in kidney tranplantation. There are strict recommended serum levels for CsA after kidney transplantation. Whether or not these levels are necessary to achieve in different ethnic groups and if changes in these levels will greatly affect the patient and graft survival are not fully addressed yet. We investigated this issue by studying the serum concentration of CsA and long term graft and patient survival in Iranian transplanted patients.
Method: From 2000 to 2006, 397 randomly selected kidney recipients were evaluated for the serum levels of CsA. All patients were under treatment with Prednisolone, MMF and CsA (ne) C2, defined as the serum CsA concentration after 2 hours of administration, was measured at different time intervals: the first 2 months, 2-6 months and after 6 months post transplantation. The mean of C2 levels at specified intervals were evaluated and compared with the recommended optimal ranges. Five year patient and graft survival rate were also calculated. In the studied patients; a lower than recommended C2 levels was observed in 96%, 83% and 65% in the first 2 months, 2-6 months and after 6 months, respectively. The overall 5 year patient and graft survival rates were 95% and 85%, respectively. Despite the great differences between the recommended and observed concentrations of C2, we found a good patient and graft survival. Our data suggests that ethnicity may be an important factor to define target serum cyclosporine concetration levels in kidney transplant patients.