Monitoring of cyclosporine levels in transplant recipients using self-administered fingerprick sampling

Clinical Transplantation
N YonanB Keevil

Abstract

Use of C(2) monitoring for cyclosporine A (CsA) microemulsion results in improved clinical outcomes vs. trough (C(0)) monitoring. Logistical issues include accurate timing of the C(2) sample; requirement for sample dilution with most standard assay techniques; and inconvenience for patients. Recently, it has been shown that CsA concentrations in capillary blood correlate closely with levels in venepuncture samples, and that liquid chromatography tandem mass spectrometry (LC-MS/MS) can analyse CsA concentration using undiluted capillary blood from fingerprick samples. In a study to assess the feasibility of CsA monitoring, 52 stable heart transplant patients were provided with kits to take fingerprick trough and C(2) blood samples at home, returning them to the laboratory by post for LC-MS/MS analysis. In total, 225 samples were provided, of which 14 (6%) were unsuitable for analysis because of clotting (n = 10) or insufficient volume (n = 4). Discomfort was not a problem and initial difficulties that some patients reported in taking the samples resolved with experience. All samples were returned by the postal system in a timely manner. Use of fingerprick assays could allow transplant physicians to have access to C(2) levels whe...Continue Reading

References

Apr 16, 2002·Clinical Therapeutics·Barry D KahanAtholl Johnston
May 23, 2002·Transplantation·Edward ColeCatherine O'Grady
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Citations

Sep 28, 2007·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Nicholas J A WebbJanice S Ellis
Feb 26, 2009·Nature Clinical Practice. Nephrology·Pleasant F HooperSander Florman
Apr 25, 2007·Drug Development and Industrial Pharmacy·Pascal R BeauchesneKishor M Wasan
Jul 24, 2010·Journal of Transplantation·Alexander Benedikt LeichtleGeorg Martin Fiedler
Oct 15, 2014·Annals of Clinical Biochemistry·Joanne E AdawayLaura J Owen
May 20, 2014·Biomedit︠s︡inskai︠a︡ khimii︠a︡·P G LokhovA I Archakov
Aug 14, 2013·Annals of Clinical Biochemistry·Edward HinchliffeBrian G Keevil

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