ABSTRACT
Cyclosporine A (CsA) is a unique cyclic peptide of fungal origin, with potent immunosuppressive properties but low myelotoxicity. It has had a major impact on organ transplantation, significantly improving 1- and 2-year graft-survival rates and decreasing morbidity in renal, hepatic, heart, heart-lung, and pancreas transplantation. The use of CsA is associated with multiple side effects. As lipoprotein profiles are altered in patients under liver transplant, the extent of CsA binding and the pharmacologic response may have been altered, producing adverse reactions such as nephrotoxicity and neurotoxicity. This chapter aims to examine the relationship of cholesterol and triglyceride, the major lipid constituents of lipoproteins, cholesterol-HDL, apolipoprotein A and B, albumin, creatinine, and CsA levels with episodes of neurotoxicity. Since lipoprotein moieties serve as a reservoir for CsA, probably transferring the drug directly into plasma membranes, lipid binding may buffer this effect.
