Individualized Neoral doses in pediatric renal transplantation. 2010

Y García, and P Muquillaza, and S Valdebenito
Luis Calvo Mackenna Hospital, Santiago, Chile. yerka@vtr.net

We propose a model to calculate individualized Neoral doses based on individual oral clearance (CL/F)(i) and AUC((0-12h)) values. The equation proposed by Dr. Ke-Hua Wu (2005), was employed to calculate the CL/F(i) = 28,5 - (1.24*POD) - 0.252*(TBil-11) + 0,188*(Weight o-58) -0,191*(Age-42) - 2,42*INHI - 0,212*(HCT-28), where CI/F = (L/h), POD = postoperative days, Bil.T = total bilirubin level (umol/L), CBW = in kilograms, age = in years, INHI = concurrent metabolic inhibitors present (1) or absence (0), and HCT = hematocrit percentage. The AUC((0-12h)) was calculated from the C(2) value using the equation AUC((0-12h)) = 815,578 + 4,44696*C(2), derived from the linear correlation observed in earlier work at Clinica Las Condes Hospital. The studied population were 30 kidney transplanted children at Luis Calvo Mackenna Hospital, between 2002 and 2006, who were divided into 2 similar groups according to accurate C(2) sampling time collections. The control group 1 was composed of 13 patients of age 9.85 +/- 4 years whose samples were collected correctly. Group 2 was composed of 17 patients of age 10.43 +/- 6 years with 252 C(2) samples, which were obtained at medical control. All patients were under oral treatment with prednisone, azathioprine, nifedipine, and Neoral administered twice day according the weight of the patient and the C(2) level. Relating Neoral administered doses to calculated doses according to the proposed model, the control group showed a linear correlation coefficient r = 0.924; r(2) = 85.4%; (P < .05), and group 2, r = 0.54; r(2) = 29.1 (P < .05). The proposed model to calculate Neoral doses had a predictive value of 85.0% when C(2) samples were collected correctly.

UI MeSH Term Description Entries
D007166 Immunosuppressive Agents Agents that suppress immune function by one of several mechanisms of action. Classical cytotoxic immunosuppressants act by inhibiting DNA synthesis. Others may act through activation of T-CELLS or by inhibiting the activation of HELPER CELLS. While immunosuppression has been brought about in the past primarily to prevent rejection of transplanted organs, new applications involving mediation of the effects of INTERLEUKINS and other CYTOKINES are emerging. Immunosuppressant,Immunosuppressive Agent,Immunosuppressants,Agent, Immunosuppressive,Agents, Immunosuppressive
D008657 Metabolic Clearance Rate Volume of biological fluid completely cleared of drug metabolites as measured in unit time. Elimination occurs as a result of metabolic processes in the kidney, liver, saliva, sweat, intestine, heart, brain, or other site. Total Body Clearance Rate,Clearance Rate, Metabolic,Clearance Rates, Metabolic,Metabolic Clearance Rates,Rate, Metabolic Clearance,Rates, Metabolic Clearance
D008954 Models, Biological Theoretical representations that simulate the behavior or activity of biological processes or diseases. For disease models in living animals, DISEASE MODELS, ANIMAL is available. Biological models include the use of mathematical equations, computers, and other electronic equipment. Biological Model,Biological Models,Model, Biological,Models, Biologic,Biologic Model,Biologic Models,Model, Biologic
D001827 Body Height The distance from the sole to the crown of the head with body standing on a flat surface and fully extended. Body Heights,Height, Body,Heights, Body
D001835 Body Weight The mass or quantity of heaviness of an individual. It is expressed by units of pounds or kilograms. Body Weights,Weight, Body,Weights, Body
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D003404 Creatinine Creatinine Sulfate Salt,Krebiozen,Salt, Creatinine Sulfate,Sulfate Salt, Creatinine
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000704 Analysis of Variance A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable. ANOVA,Analysis, Variance,Variance Analysis,Analyses, Variance,Variance Analyses
D001663 Bilirubin A bile pigment that is a degradation product of HEME. Bilirubin IX alpha,Bilirubin, (15E)-Isomer,Bilirubin, (4E)-Isomer,Bilirubin, (4E,15E)-Isomer,Bilirubin, Calcium Salt,Bilirubin, Disodium Salt,Bilirubin, Monosodium Salt,Calcium Bilirubinate,Hematoidin,delta-Bilirubin,Bilirubinate, Calcium,Calcium Salt Bilirubin,Disodium Salt Bilirubin,Monosodium Salt Bilirubin,Salt Bilirubin, Calcium,delta Bilirubin

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