Low bioavailability of cyclosporine microemulsion and tacrolimus in a small bowel transplant recipient: Possible relationship to intestinal P- glycoprotein activity

Bruce Kaplan, Ken Lown, Robert Craig, Michael Abecassis, Dixon Kaufman, Joseph Leventhal, Frank Stuart, Herwig Ulf Meier-Kriesche, Jonathan Fryer

    Research output: Contribution to journalArticle

    52 Scopus citations

    Abstract

    With intestine transplants the allograft is dependent on itself for maintenance of adequate immunosuppression. We evaluated an intestinal transplant recipient who required very large doses of either tacrolimus or cyclosporine emulsion to achieve acceptable blood concentrations. Pharmacokinetic studies revealed bioavailabilities of 2% and 6% respectively, while D-xylose and B12 absorption were found to be within normal limits and fecal fat was only slightly increased, suggesting that there was a selective absorptive defect for these drugs. Biopsies of the allograft ileum revealed a high P-glycoprotein activity compared to the jejunum or to intestinal biopsies from other normal subjects. This may be a contributing factor to poor immunosuppressive drug absorption in this patient and others.

    Original languageEnglish (US)
    Pages (from-to)333-335
    Number of pages3
    JournalTransplantation
    Volume67
    Issue number2
    DOIs
    StatePublished - Jan 27 1999

    ASJC Scopus subject areas

    • Transplantation

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