{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T06:42:25Z","timestamp":1777704145141,"version":"3.51.4"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2004,2,1]],"date-time":"2004-02-01T00:00:00Z","timestamp":1075593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2004,1,30]],"date-time":"2004-01-30T00:00:00Z","timestamp":1075420800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2004,2]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>After orthotopic liver transplantation (OLT) many patients use emulsified cyclosporine. Recent data showed that blood levels 2 hours after dosing (C-2) better reflect systemic exposure to the drug (area under the blood concentration time curve) than trough levels (C-0) do. We investigated difference in dosage, creatinine clearance (CrCl), blood pressure (BP), freedom from rejection, and relation of C-2, C-0, and AUC while switching 31 stable patients more than 6 months after OLT from C-0 to C-2 monitoring. With C-0 between 90 and 150 ng\/mL we collected 24-hour urine, while blood samples were taken at t = 0, 1, 2, 3, 4, 6, and 8 hours after dosing to measure cyclosporine, creatinine, liver tests, and blood pressure and calculated AUC and CrCl. Target AUC was calculated based on C-0. Then the dose was adjusted to two subsequent C-2 values of 600 ng\/mL \u00b1 15%, the above was repeated, and the differences were assessed. Cyclosporine dose was reduced in 21\/31 patients (68%) and remained unchanged in 10\/31 patients (32%) after conversion. Mean lowering was 69 mg daily (26.9 %, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.0001). After dose reduction the mean increase of CrCl was 7.93 ml\/min (11.6%, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.016). Only systolic and mean morning BP decreased slightly but significantly. C-2 correlated better with AUC <jats:sub>0-12<\/jats:sub> (r<jats:sup>2<\/jats:sup> = 0.75) than C-0 (r<jats:sup>2<\/jats:sup> = 0.64). However, 13\/21 patients had a second AUC below target AUC and 2 of these 13 patients developed rejection after conversion to C-2 levels. In conclusion, while C-0 monitoring frequently results in overdosing and more renal dysfunction, C-2 monitoring may lead to episodes of underdosing and rejection. Therefore better ways of monitoring cyclosporine dosing need to be devised. (Liver Transpl 2004;10:183-189.)<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/lt.20056","type":"journal-article","created":{"date-parts":[[2004,1,31]],"date-time":"2004-01-31T00:00:52Z","timestamp":1075507252000},"page":"183-189","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":16,"title":["Switching monitoring of emulsified cyclosporine from trough level to 2-hour level in stable liver transplant patients"],"prefix":"10.1097","volume":"10","author":[{"given":"Pieter","family":"Langers","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serge C.L.M.","family":"Cremers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"den Hartigh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roeland A.","family":"Veenendaal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rogier W.","family":"ten Hove","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Ringers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cornelis B.H.W.","family":"Lamers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bart","family":"van Hoek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"issue":"13","key":"R1-3-20250326","first-page":"19572016","article-title":"Cyclosporine: an updated review of the pharmacokinetic properties, clinical efficacy and tolerability of a microemulsion-based formulation (Neoral) in organ transplantation.","volume":"61","author":"Dunn","year":"2001","journal-title":"Drugs"},{"issue":"5","key":"R2-3-20250326","doi-asserted-by":"crossref","first-page":"279290","DOI":"10.2165\/00063030-200115050-00001","article-title":"C2 monitoring strategy for optimising cyclosporine immunosuppression from the Neoral formulation.","volume":"15","author":"Levy","year":"2001","journal-title":"BioDrugs"},{"issue":"suppl","key":"R3-3-20250326","first-page":"39","article-title":"Clinical validation studies of Neoral C2 monitoring: a review.","volume":"73","author":"Nashan","year":"2002","journal-title":"Transplantation"},{"key":"R4-3-20250326","doi-asserted-by":"crossref","first-page":"18391842","DOI":"10.1097\/00007890-199912270-00003","article-title":"Clinical benefit of Neoral dose monitoring with cyclosporinee 2-hour post-dose levels compared with trough levels in stable heart transplant patients.","volume":"68","author":"Cantarovich","year":"1999","journal-title":"Transplantation"},{"key":"R5-3-20250326","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/S1053-2498(01)00680-5","article-title":"Clinical utility of cyclosporine C2 monitoring after lung transplantation.","volume":"21","author":"Glanville","year":"2002","journal-title":"J Heart Lung Transplant"},{"issue":"12","key":"R8-3-20250326","first-page":"16211627","article-title":"Comparison of neoral dose monitoring with cyclosporinee trough levels versus 2-hr postdose levels in stable liver transplant patients.","volume":"66","author":"Cantarovich","year":"1998","journal-title":"Transplantation December"},{"issue":"8","key":"R9-3-20250326","first-page":"11331137","article-title":"Peak cyclosporinee levels (Cmax) correlate with freedom from liver graft rejection: results of a prospective, randomized comparison of neoral and sandimmune for liver transplantation (NOF-8).","volume":"67","author":"Grant","year":"1999","journal-title":"Transplantation April"},{"key":"R10-3-20250326","first-page":"30923093","article-title":"JR, for the Neo-INT-06 Study Group. 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