My major academic interest is the field of human renal transplantation. I have obtained extensive clinical training in this area, and have been practicing this discipline continuously for the past two years as an Assistant Professor at the University of Texas. Although I continue to acquire judgment and sophistication in the management of renal transplant recipients, further contributions to this field will require a more direct involvement in laboratory research. During the past year, with the aid of a Biomedical Research Support Grant from the University of Texas, I have been able to embark on direct laboratory investigation into the assessment of the immune status of Cyclosporine treated patients. I hope that this Clinical Investigator Award would permit me to solidify my laboratory training so that I will qualify as an independent investigator in the future. I feel that with adequate time and support, I can master basic immunologic techniques, propose hypotheses, and attempt to solve problems directly related to human organ transplantation. The purpose of this project is to develop in-vitro methods to quantitate the degree of immune suppression in successful renal allograft recipients. With laboratory discrimination of the immune status of patients it may be possible to tailor immunosuppressive drugs selectively for each patient. The introduction of Cyclosporine into clinical transplantation may provide a window whereby patients can be maintained without corticosteroids. The use of Cyclosporine alone would permit increased rehabilitation of the transplant recipient without steroid related longterm complications. These complications add significant morbidity to patients and cost to the ESRD program. The environment at the University of Texas affords me a unique opportunity to meet these goals. Available to me are established laboratory facilities with all the fixed equipment necessary for this project; the largest renal transplant center in Texas, which was a pilot center for the use of Cyclosporine in this country, and the guidance and counsel of two established investigators who are familiar with the methodology and goals of this project: Dr. Ronald H. Kerman and Dr. Barry D. Kahan.
| Lum, B L; Tam, J; Kaubisch, S et al. (1992) Arithmetic versus harmonic mean values for cyclosporin-A pharmacokinetic parameters. J Clin Pharmacol 32:911-4 |
| Flechner, S M; Kolbeinsson, M C; Lum, B et al. (1989) The effect of obesity on cyclosporine pharmacokinetics in uremic patients. Transplant Proc 21:1446-8 |
| Flechner, S M; Kolbeinsson, M E; Tam, J et al. (1989) The impact of body weight on cyclosporine pharmacokinetics in renal transplant recipients. Transplantation 47:806-10 |
| Flechner, S M; Kerman, R H; Van Buren, C T et al. (1987) Does cyclosporine improve the results of HLA-identical renal transplantation? Transplant Proc 19:1485-8 |
| Flechner, S M; Van Buren, C T; Kerman, R H et al. (1986) Long-term results of cyclosporine therapy in recipients of mismatched living related kidneys. Transplant Proc 18:44-51 |
