Relation of C-2 Monitoring With Serum Lipid Profile in Stable Renal Transplant Patients

• Published in: Transplantation proceedings 2006-03, Vol.38 (2), p.460-462
• Main Authors: Akbas, S.H., Yurdakonar, E., Yucetin, L., Senol, Y., Tuncer, M., Kocak, H., Akbas, M., Gurkan, A., Demirbas, A., Gultekin, M.
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Cyclosporine - pharmacology; Cyclosporine - therapeutic use; Drug Therapy, Combination; Environmental Monitoring - methods; Epidemiological Monitoring; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Hypercholesterolemia - epidemiology; Immunosuppressive Agents - pharmacology; Immunosuppressive Agents - therapeutic use; Kidney Transplantation - immunology; Kidney Transplantation - physiology; Kinetics; Lipids - blood; Male; Medical sciences; Middle Aged; Mycophenolic Acid - analogs & derivatives; Mycophenolic Acid - therapeutic use; Prednisolone - therapeutic use; Retrospective Studies; ROC Curve; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue, organ and graft immunology
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2005.12.088

C-2 monitoring has been proposed as a more effective strategy than C-0 to predict the risk of acute rejection in the early stages posttransplantation. However, cyclosporine (CsA) is associated with posttransplant dyslipidemia. The aim of this retrospective study was to evaluate the correlations of C-0 and C-2 levels with atherogenic risk factors in the first 6 months versus after 6 months posttransplantation. We evaluated the data from 127 stable renal transplant recipients (89 males, 38 females) of mean age 38.10 ± 12.79 years who received Neoral-based immunosuppression to investigate the relation of C-2 levels to serum lipid profile compared with C-0 values in the early and late posttransplantation periods. Receiver operating characteristic (ROC) analyses were performed to define a C-2 cutoff level that identified subjects with hypercholesterolemia, defined as a total cholesterol (TC) >200 mg/dL. There were significant positive correlations between both C-0 and C-2 levels and TC as well as the ratio of total cholesterol/HDL cholesterol (TC/HDL) in the late period. When the C-2 levels in the late posttransplantation period were stratified, serum TC concentrations showed statistically significant differences between the groups. Whole blood C-2 levels above 850 ng/mL were associated with increased serum TC concentrations; the C-2 cutoff level leading to hypercholesterolemia was 888 ng/mL. Maintenance immunosuppressive therapy under the proposed whole blood C-2 level of 888 ng/mL seemed to preserve graft function while preventing atherogenic risks for cardiovascular diseases in the late posttransplantation period.