Neoral use in the renal transplant recipient.

This review and critical analysis of current trends of immunosuppression management in pediatric transplantation provides evidence and support for the continued role of Neoral as an indispensable part of immunosuppressive protocols. CyA formulation influences clinical outcomes such as acute rejection, as confirmed by several multicenter studies. The CyA microemulsion formulation reduces pharmacokinetic variability and its consequent impact on outcomes over the long term. An advanced TDM strategy can improve the effectiveness and safety of immunosuppression in both de novo and maintenance renal transplant patients. There are potential risks resulting from CyA withdrawal strategies. Neoral is an indispensable part of combination protocols in renal transplantation.