Two-year follow-up of the pharmacokinetics of immunosuppressive drugs in a neonate who underwent heart transplantation

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Abstract

The pharmacokinetic properties of immunosuppressive drugs are quite different in newborns than in adults and few studies describe the pharmacokinetics of these drugs in pediatric heart transplant recipients. We report on the two-year follow up of a neonate who underwent heart transplantation for Hypoplastic Left Heart Syndrome on day of life 9. Two different immunosuppressive regimens were used: cyclosporine, azathioprine and prednisone in the early postoperative period, followed by the routine tacrolimus and mycophenolate mofetil combination plus prednisone from post-transplant day 22. Our findings demonstrate marked variability in immunosuppressive pharmacokinetic profiles early post-transplant. Frequent monitoring of drug levels is required to ensure that they remain within the therapeutic range. After the first 23 months post-transplant, changes in immunosuppressive drug levels are less marked and correlate more with the administered dosage.

Original languageEnglish
Pages (from-to)108-110
Number of pages3
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume22
Issue numberSUPPL. 3
DOIs
Publication statusPublished - 2009

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Heart Transplantation
Immunosuppressive Agents
Pharmacokinetics
Newborn Infant
Prednisone
Transplants
Pharmaceutical Preparations
Hypoplastic Left Heart Syndrome
Mycophenolic Acid
Drug Monitoring
Azathioprine
Tacrolimus
Postoperative Period
Cyclosporine
Pediatrics
Therapeutics

Keywords

  • Follow-up
  • Heart transplantation
  • Immunosuppressive drugs
  • Newborn
  • Pharmacokinetics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynaecology

Cite this

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title = "Two-year follow-up of the pharmacokinetics of immunosuppressive drugs in a neonate who underwent heart transplantation",
abstract = "The pharmacokinetic properties of immunosuppressive drugs are quite different in newborns than in adults and few studies describe the pharmacokinetics of these drugs in pediatric heart transplant recipients. We report on the two-year follow up of a neonate who underwent heart transplantation for Hypoplastic Left Heart Syndrome on day of life 9. Two different immunosuppressive regimens were used: cyclosporine, azathioprine and prednisone in the early postoperative period, followed by the routine tacrolimus and mycophenolate mofetil combination plus prednisone from post-transplant day 22. Our findings demonstrate marked variability in immunosuppressive pharmacokinetic profiles early post-transplant. Frequent monitoring of drug levels is required to ensure that they remain within the therapeutic range. After the first 23 months post-transplant, changes in immunosuppressive drug levels are less marked and correlate more with the administered dosage.",
keywords = "Follow-up, Heart transplantation, Immunosuppressive drugs, Newborn, Pharmacokinetics",
author = "Mario Regazzi and Gianfranco Perotti and Carlo Pellegrini and Molinaro, {Maria Delfina} and Chryssoula Tzialla and Rita Cabano and D'Armini, {Andrea Maria} and Mauro Stronati and Mario Vigan{\'o}",
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AU - Regazzi, Mario

AU - Perotti, Gianfranco

AU - Pellegrini, Carlo

AU - Molinaro, Maria Delfina

AU - Tzialla, Chryssoula

AU - Cabano, Rita

AU - D'Armini, Andrea Maria

AU - Stronati, Mauro

AU - Viganó, Mario

PY - 2009

Y1 - 2009

N2 - The pharmacokinetic properties of immunosuppressive drugs are quite different in newborns than in adults and few studies describe the pharmacokinetics of these drugs in pediatric heart transplant recipients. We report on the two-year follow up of a neonate who underwent heart transplantation for Hypoplastic Left Heart Syndrome on day of life 9. Two different immunosuppressive regimens were used: cyclosporine, azathioprine and prednisone in the early postoperative period, followed by the routine tacrolimus and mycophenolate mofetil combination plus prednisone from post-transplant day 22. Our findings demonstrate marked variability in immunosuppressive pharmacokinetic profiles early post-transplant. Frequent monitoring of drug levels is required to ensure that they remain within the therapeutic range. After the first 23 months post-transplant, changes in immunosuppressive drug levels are less marked and correlate more with the administered dosage.

AB - The pharmacokinetic properties of immunosuppressive drugs are quite different in newborns than in adults and few studies describe the pharmacokinetics of these drugs in pediatric heart transplant recipients. We report on the two-year follow up of a neonate who underwent heart transplantation for Hypoplastic Left Heart Syndrome on day of life 9. Two different immunosuppressive regimens were used: cyclosporine, azathioprine and prednisone in the early postoperative period, followed by the routine tacrolimus and mycophenolate mofetil combination plus prednisone from post-transplant day 22. Our findings demonstrate marked variability in immunosuppressive pharmacokinetic profiles early post-transplant. Frequent monitoring of drug levels is required to ensure that they remain within the therapeutic range. After the first 23 months post-transplant, changes in immunosuppressive drug levels are less marked and correlate more with the administered dosage.

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KW - Immunosuppressive drugs

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