Distribution of cyclosporine in blood of a renal-transplant recipient with type V hyperlipoproteinemia

H. L. Verrill, R. E. Girgis, R. E. Easterling, B. S. Malhi, W. F. Mueller

Research output: Contribution to journalArticlepeer-review

Abstract

A patient with severe type V hyperlipoproteinemia and chronic end-stage renal disease received a renal transplant and therapy with cyclosporine. Concentrations of the drug in plasma as determined by liquid chromatography appeared extraordinarily high for the dose ingested. When we measured the drug in the plasma, plasma cleared by ultracentrifugation, leukocytes, erythrocytes, and whole blood, we found that the high concentrations of cyclopsorine were associated with the chylomicrons that always were present in this patient's blood. Cyclosporine added directly to this patient's plasma was less associated with the plasma lipids. Isolated lymphocytes and kidney slices incubated with plasma from this patient bound no more drug than when incubated with nonhyperlipemic plasma containing cyclosporine at a normal therapeutic concentration. We conclude that the cyclosporine associated with the chylomicrons in this patient was not biologically available to either lymphocytes or kidney tissue. We strongly recommend the use of chylomicron-cleared plasma for therapeutic drug monitoring of cyclosporine in type V hyperlipoproteinemic patients.

Original languageEnglish (US)
Pages (from-to)423-428
Number of pages6
JournalClinical chemistry
Volume33
Issue number3
StatePublished - Dec 1 1987

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Biochemistry, medical

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