Therapeutic whole-blood levels of cyclosporin A in heart and lung transplantation.

The use of cyclosporin A (CyA) as an immunosuppressive drug is limited because of its serious side effects. In order to minimise these toxic side effects while utilising immunosuppressive properties of CyA, the dosage of CyA is generally administered on the basis of the individual CyA whole blood level. Therefore, a frequent determination of CyA whole blood levels is necessary. The aim of our study was to establish therapeutic whole blood levels for patients after heart (HTX) and lung (LuTX) transplantation depending on the interval of time after transplantation. CyA levels were determined by HPLC and by fluorescence polarisation immunoassay (FPIA) with a monoclonal and a polyclonal antibody. Two hundred and ninety-five patients after HTX and 48 patients after LuTX were investigated and patients with rejection and/or pathological kidney and liver function were excluded. No significant differences between the two groups of patients were detected. Therefore, common therapeutic ranges for CyA can be used for adequate immunosuppression for patients after HTX and LuTX.