Cyclosporine (CsA) has a narrow therapeutic window. Studies suggest that the serum level of CsA be kept strictly at specified level. But it’s not well understood whether failing to maintain these serum levels will affect the overall outcome of the patients in different ethnicities. In this study we aimed to compare the outcome of the Iranian kidney recipients with or without recommended serum CsA levels.
Methods: We included 265 consecutive kidney transplant recipients, transplanted in Baqiyatallah hospital, Tehran, Iran. We followed each recipient for at least 3 years. The serum level of CsA, 2 hours after administration (C2) the most recommended indicator of CsA - were assessed. Patients were then divided into two groups, according to mean C2 levels in the first 6 month after transplantation: Group I, (n=213) consisted of patients with C2 levels within the recommended range and Group II (n=52) included patients with lower than recommended ranges. Two groups had no significant difference in age and baseline Cr. Three-year Graft survival rate was compared in two groups.Three year graft survival was 69% in group I and 89% in group II, which showed no statistically significant difference (p>0.05).
Conclusions: The result of this study - against the general belief-suggests that in our patient population, having C2 levels in the recommended range does not essentially accompany with a better graft survival. This finding suggests that in different ethnic groups, the optimal level of C2 should be determined specificually.