Abstract
Therapeutic drug monitoring (TDM) is essential to maintain the efficacy of immunosuppressant drugs while minimizing their toxicity. The area under the concentration-time curve over the first 4 hours post-dose (AUC0-4) has been reported to be useful for accurate TDM. However, AUC0-4 is difficult for out-patients due to collecting blood five times. The estimated AUC 0-4 is method of estimate the AUC0-4 with gathering blood three time-point. We examined the utility of estimated AUC 0-4 in pediatric kidney transplantation patients. The AUC0-4 correlated better with estimated AUC0-4 (cyclosporin: r2=0.874, tacrolimus: r2=0.967) than with concentration measurement 2 hour after administration (r2=0.648, 0.695). The estimated AUC0-4 was very useful TDM for pediatric kidney transplantation patients.
We also examined optimal starting dose of immunosuppressant drugs. The optimal dose of cyclosporine was 11 mg per kg regardless of patient's body weight. On the other hand, concerning tacrorimus, patients with lower body weight required a higher dosage.
