Comparison of three estimators for determining cyclosporine dosing in infants after liver transplantation

To compare and analyze how allometrically- and linearly-scaled daily doses of cyclosporine could affect the therapeutic drug monitoring concentrations when applied to 8 infants with liver transplants. Eight infants who underwent liver transplantations were put on twice-daily oral cyclosporine immunosuppressive regimens. After starting therapy, the adjustments of individual daily doses were determined by using therapeutic monitoring of plasma cyclosporine levels by measuring trough concentrations (C ) and concentrations at 2 hours after drug administration (C ). These doses were analyzed and compared with the hypothetical doses estimated by allometric and linear scaling in order to compare which of the two methods would yield closer estimates to the actual doses applied. The median therapeutic drug monitoring (TDM)-based dose (n = 53) was 70.00 mg (10.9 mg/kg/day) (5.00 - 190.00 mg), whereas the median allometric (n = 53) and linear (n = 53) doses were 65.21 mg (10.11 mg/kg/day) (57.17 - 79.25 mg) and 35.63 mg (5.52 mg/kg/day) (29.89 - 46.20 mg), respectively. The median allometric dose was significantly different than the median linear dose (p