Blood cyclosporine C0 and C2 concentrations and cytomegalovirus infections following lung transplantation

The aim of this study was to determine whether cyclosporine levels predose (C-0) and at two hours postdose (C-2) were higher among patients presenting with cytomegalovirus (CMV) infection or disease. Between days 40 and 365 posttransplantation serial C-0 and C-2 levels were measured in 15 lung transplant recipients. Nine developed 13 episodes of CMV infection or disease. Both C-0 and C-2 levels were higher during CMV infection or disease episodes. Eleven of the 13 CMV episodes (84%) displayed C-0 > 220 ng/mL and none had C-0 < 200 ng/mL. For C-2, 11 of 13 CMV episodes (84%) showed C-2 > 1200 ng/mL and none had C-2 < 1000 ng/mL. Among determinations that did not coincide with a CMV episode, 7 of 21 (33%) showed C-0 > 220 and 9 of 21 (42%) showed C-2 > 1200, respectively (P < .05). In conclusion, cyclosporine blood levels are higher among patients presenting with CMV infection or disease.