ABSTRACT
Since the introduction of cyclosporine A (CsA) for the immunosuppression in solid-organ transplantation, the rate of allograft rejection has decreased substantially. However, its use is associated with multiple side effects, such as nephrotoxicity, hypertension, and neurotoxicity. Patients with high levels of CsA, concurrent high-dose methylprednisolone treatment, hypertension, or hypermagnesemia have been associated with central nervous system (CNS) side effects. In pediatric patients undergoing liver transplantation, the authors have tried to associate the level of CsA and magnesium (Mg) with CNS side effects such as seizures, tremors, agitation, psychosis, and confusion. Serum magnesium determinations were performed by atomic absorption spectrophotometry and cyclosporine A metabolites by a nonspecific polyclonal radioimmunoassay. The administration of drugs that cause renal Mg wasting (aminoglycosides, digoxin, furosemide, amphotericin B, cyclosporine, etc) had been associated with the development of hypomagnesemia, and that with the neurotoxicity ascribed to CsA.
