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8408250 
Journal Article 
Therapeutic drug monitoring of cyclosporin-A following the first heart transplantation in Guangxi Zhuang Autonomous Region of China 
Wu, M; Liang, CF; Wu, HW; Zhou, LF 
2009 
No 
Journal of Clinical Rehabilitative Tissue Engineering Research
ISSN: 1673-8225 
13 
44 
8783-8786 
English 
BACKGROUND: Due to the difference in bioavailability and pharmacokinetics of cyclosporine A (CsA) among different individuals, it is of great importance to carry out blood drug concentration monitoring for safety, effectiveness and reduction of acute immunological rejection. OBJECTIVE: To develop a method of blood drug concentration determination of CsA after the heart transplantation, and to analyze the correlation between dose, outcome and concentration so as to develop an optimal administration scheme. DESIGN, TIME AND SETTING: Controlled sample observation was conducted between August and September 2003 at the Clinical Pharmaceutic Laboratory, Fourth Affiliated Hospital, Guangxi Medical University. PARTICIPANT: Heart transplantation patient in the Guangxi Zhuang Autonomous Region was treated with CsA capsule, prednisone and mycophenolate mofetil. METHODS: 3 mL venous blood was taken from the receptor before taking medicine in the morning. As an anticoagulant, heparin was added and misced bene. 10 μL CsB, the in internal standard fluid was inserted into a 10 mL glass tube, which was added with 1 mL whole blood and 1 mL NaOH (0.2 mol/L) and misced bene. The supernatant was put into another tube and dried out at 60°C, again cooled to room temperature and added with 100 μL solution of 0.05 mol/L acid hydroc and acetonitrile plus 400 μL N-hexane, which was centrifuged for 5 minutes, and 20 μL from lower layer was taken for sample injection. A high efficiency liquid chromatography was used with cyclosporine-B as the internal standard, the patient blood concentration of CsA was detected at 214 nm and the dose was adjusted accordingly. MAIN OUTCOME MEASURES: Whether patients occurred acute rejection or not, and blood drug concentration of CsA were measured. RESULTS: High efficiency liquid chromatography showed good resolving power. The absolute recoveries were not lower than 75%. Monitoring results demonstrated that the highest concentration occurred 10 days after transplantation. The dose was regulated according to results. Peak concentration was between 200-300 μg/L 14 days following transplantation, and acute rejection did not occur in recipients. CONCLUSION: High efficiency liquid chromatography can satisfy the demand of general clinic determination of blood concentration of CsA. Peak concentration between 200-300 μg/L 14 days following transplantation is suitable.