Clinical Chemistry, Vol 36, 1510-1516, Copyright © 1990 by American Association for Clinical Chemistry

Consensus document: Hawk's Cay meeting on therapeutic drug monitoring of cyclosporine

BD Kahan, LM Shaw, D Holt, J Grevel and A Johnston
Division of Immunology and Organ Transplantation, University of Texas Medical School, Houston 77030.

The optimal measurement method and clinical application of the therapeutic drug monitoring of cyclosporine remain uncertain. At a workshop held at Hawk's Cay, FL, from January 14 to January 17, 1990, 57 scientists presented their latest research findings, either in formal papers or as discussants. Lively debate and discussion followed presentation of extant and new methodologies for drug measurements as well as multicenter validation studies: applications of trough- concentration monitoring in renal, hepatic, and bone-marrow transplants as well as in autoimmune disease; and alternative pharmacokinetic approaches to guide cyclosporine therapy. The process of inducing and maintaining optimal immunosuppression to facilitate graft success is a complex and often challenging task, requiring the combined expertise of multiple disciplines. Thus, the assembly of four of the groups essential to the transplant process--clinicians, laboratory scientists, the pharmaceutical company, and the manufacturers of cyclosporine measurement kits--provided a unique opportunity to evaluate therapeutic drug monitoring issues facing the transplant field. Here we present the major conclusions reached at the meeting, brief discussions of the study data on which they are based, and a summary of unresolved problems that will require further rigorous investigations. The Consensus Document was reviewed by all the workshop participants before we submitted this final manuscript.

The following articles in journals at HighWire Press have cited this article:

				R. G Morris Immunosuppressant Drug Monitoring: Is the Laboratory Meeting Clinical Expectations? Ann. Pharmacother., January 1, 2005; 39(1): 119 - 127. [Abstract] [Full Text] [PDF]

				A. R. Terrell, T. M. Daly, K. G. Hock, D. C. Kilgore, T. Q. Wei, S. Hernandez, D. Weibe, L. Fields, L. M. Shaw, and M. G. Scott Evaluation of a No-Pretreatment Cyclosporin A Assay on the Dade Behring Dimension RxL Clinical Chemistry Analyzer Clin. Chem., July 1, 2002; 48(7): 1059 - 1065. [Abstract] [Full Text] [PDF]

				R. Caruso, N. Perico, D. Cattaneo, G. Piccinini, S. Bonazzola, G. Remuzzi, and F. Gaspari Whole-Blood Calcineurin Activity Is Not Predicted by Cyclosporine Blood Concentration in Renal Transplant Recipients Clin. Chem., September 1, 2001; 47(9): 1679 - 1687. [Abstract] [Full Text] [PDF]

				W. Steimer Performance and Specificity of Monoclonal Immunoassays for Cyclosporine Monitoring: How Specific Is Specific? Clin. Chem., March 1, 1999; 45(3): 371 - 381. [Abstract] [Full Text] [PDF]

				L. M. Shaw, B. Kaplan, and K. L. Brayman Prospective investigations of concentration–clinical response for immunosuppressive drugs provide the scientific basis for therapeutic drug monitoring Clin. Chem., February 1, 1998; 44(2): 381 - 387. [Abstract] [Full Text] [PDF]