Cyclosporine pharmacokinetics in diabetic patients after kidney and pancreas transplantation

Adequate cyclosporine (Csa) therapy that avoids rejection and nephrotoxicity remains to be defined. We observed that diabetic patients submitted to combined renal and pancreatic transplantation required a higher dose of Csa than renal transplant recipients to obtain similar blood trough levels. We performed a pharmacokinetic study using HPLC to compare Csa metabolism in both groups and found that renal and pancreatic transplant recipients have an impaired gastro‐intestinal Csa resorption. Moreover, when those patients were reoperated, we observed a significant fall in Csa bioavailability. Whether this impaired Csa resorption is due to surgical procedures or to digestive tract abnormalities needs further investigation.