BACKGROUND: Finger-prick sampling is an alternative strategy for monitoring immunosuppressive drug concentrations that could be useful in reducing outpatient visits. We investigated the correlation between venous and finger-prick samples in a group of adult thoracic transplant patients. METHODS: Blood samples (n = 65) for the measurement of whole blood tacrolimus were collected from adult heart (n = 18) and lung transplant (n = 20) recipients receiving tacrolimus-based immunosuppressive therapy and a finger-prick sample was taken at the same time. RESULTS: Between-batch assay imprecision (coefficient of variation [CV], %) for the last 12 months (n = 270) at concentrations of 3.5, 6.9 and 13.9 microg/L was 8.0%, 5.4% and 5.2%, respectively. Passing and Bablok regression analysis between finger-prick and venous blood showed finger-prick tacrolimus = 1.02 (venous blood tacrolimus) -0.06. Bland-Altman analysis showed good agreement with a bias of 0.114 microg/L and 95% limits of agreement from -1.0 to 1.2 microg/L. CONCLUSIONS: The liquid chromatography mass spectrometry methodology that we have developed has the potential to allow patients or their carers to collect finger-prick blood samples at home and send them to the laboratory using the routine mail service. We believe that finger-prick blood sampling has an important role to play in the care of transplant patients receiving immunosuppressive drugs, including tacrolimus.
BACKGROUND: Finger-prick sampling is an alternative strategy for monitoring immunosuppressive drug concentrations that could be useful in reducing outpatient visits. We investigated the correlation between venous and finger-prick samples in a group of adult thoracic transplant patients. METHODS: Blood samples (n = 65) for the measurement of whole blood tacrolimus were collected from adult heart (n = 18) and lung transplant (n = 20) recipients receiving tacrolimus-based immunosuppressive therapy and a finger-prick sample was taken at the same time. RESULTS: Between-batch assay imprecision (coefficient of variation [CV], %) for the last 12 months (n = 270) at concentrations of 3.5, 6.9 and 13.9 microg/L was 8.0%, 5.4% and 5.2%, respectively. Passing and Bablok regression analysis between finger-prick and venous blood showed finger-prick tacrolimus = 1.02 (venous blood tacrolimus) -0.06. Bland-Altman analysis showed good agreement with a bias of 0.114 microg/L and 95% limits of agreement from -1.0 to 1.2 microg/L. CONCLUSIONS: The liquid chromatography mass spectrometry methodology that we have developed has the potential to allow patients or their carers to collect finger-prick blood samples at home and send them to the laboratory using the routine mail service. We believe that finger-prick blood sampling has an important role to play in the care of transplant patients receiving immunosuppressive drugs, including tacrolimus.
Authors: Tom C Zwart; Sumit R M Gokoel; Paul J M van der Boog; Johan W de Fijter; Dina M Kweekel; Jesse J Swen; Henk-Jan Guchelaar; Dirk Jan A R Moes Journal: Br J Clin Pharmacol Date: 2018-10-15 Impact factor: 4.335
Authors: Touraj Shokati; Nicholas Bodenberger; Holly Gadpaille; Björn Schniedewind; Alexander A Vinks; Wenlei Jiang; Rita R Alloway; Uwe Christians Journal: J Vis Exp Date: 2015-11-08 Impact factor: 1.355