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Cyclosporine Absorption Following Orthotopic Liver Transplantation

Burckart, Gilbert J and Venkataramanan, Raman and Ptachcinski, Richard J and Starzl, Thomas E and Gartner, J Carlton and Zitelli, Basil J and Malatack, Jeffrey J and Shaw, Byers W and Iwatsuki, Shunzaburo and VAN Thiel, David H (1986) Cyclosporine Absorption Following Orthotopic Liver Transplantation. The Journal of Clinical Pharmacology, 26 (8). 647 - 651. ISSN 0091-2700

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Abstract

<jats:p>Blood concentrations of cyclosporine were determined in adult and pediatric patients following orthotopic liver transplantation to quantitate cyclosporine blood clearance and oral absorption. Seventeen bioavailability studies were performed following transplantation surgery in nine children and seven adults. The intravenous cyclosporine study was performed following an average dose of 2.1 mg/kg. The patients were again studied when they received the same intravenous dose plus an oral dose of cyclosporine of 8.6 mg/kg or an oral dose alone. Blood samples were collected and analyzed for cyclosporine using high‐performance liquid chromatography. Cyclosporine blood clearance ranged from 29 to 203 mL/min (1.9–21.5 mL/min/kg) in children and from 253 to 680 mL/min (3.2–7.6 mL/min/kg) in adults. The mean cyclosporine clearance value was 9.3 mL/min/kg in the pediatric patients and 5.5 mL/min/kg in the adults. Cyclosporine bioavailability was less than 5% in six studies on five pediatric patients in the immediate postoperative period. The bioavailability varied from 8% to 60% in adult liver transplant patients (mean, 27%). We conclude that: (1) cyclosporine clearance is highly variable between patients, (2) pediatric patients clear the drug more rapidly than adults and therefore need a higher cyclosporine dose on a body weight basis, (3) cyclosporine is poorly and variably absorbed in liver transplant patients, and (4) cyclosporine blood concentration monitoring is essential following orthotopic liver transplantation.</jats:p>


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Burckart, Gilbert J
Venkataramanan, Ramanrv@pitt.eduRV
Ptachcinski, Richard J
Starzl, Thomas Etes11@pitt.eduTES11
Gartner, J Carlton
Zitelli, Basil J
Malatack, Jeffrey J
Shaw, Byers W
Iwatsuki, Shunzaburo
VAN Thiel, David H
Centers: Other Centers, Institutes, Offices, or Units > Thomas E. Starzl Transplantation Institute
Date: 12 November 1986
Date Type: Publication
Journal or Publication Title: The Journal of Clinical Pharmacology
Volume: 26
Number: 8
Publisher: Wiley
Page Range: 647 - 651
DOI or Unique Handle: 10.1002/j.1552-4604.1986.tb02966.x
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0091-2700
Other ID: uls-drl:31735062116078, Starzl CV No. 644
Date Deposited: 08 Apr 2010 17:10
Last Modified: 22 Oct 2023 22:55
URI: http://d-scholarship.pitt.edu/id/eprint/4030

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