Clinical application of a dried blood spot assay for sirolimus and everolimus in transplant patients

VAMS microsampling found no significant difference from venous blood for tacrolimus in paediatric patients; samples were stable for 14 days, with average difference between paired at-home samples of 0.12 ± 0.94 ng/mL.

VAMS and parallel-reaction-monitoring mass spectrometry for tacrolimus trough measurements at home in paediatric heart-transplant patients — Zhao et al., J. Mass Spectrometry and Advances in the Clinical Lab · source ↗

• vams
• venous-agreement
• acceptability
• blood
• dbs
• tdm
• self-collection
• dried
• capillary
• pediatric
• immunosuppressants
• validation

Clinical validation for tacrolimus and mycophenolic acid monitoring showed that while volumetric absorptive microsampling met analytical criteria after concentration correction, conventional dried blood spots achieved superior adherence to strict clinical criteria, sample quality, and cost efficiency without significant haematocrit bias.

Comparison of conventional dried blood spots and volumetric absorptive microsampling for tacrolimus and mycophenolic acid determination — Paniagua-González et al., Journal of pharmaceutical and biomedical analysis (paywalled) · source ↗

• blood
• dried
• capillary
• vams
• dbs
• neoteryx-mitra
• self-collection
• validation
• venous-agreement
• tdm
• immunosuppressants
• economics
• haematocrit

Volumetric dried blood spot sampling showed good agreement with conventional venous sampling for tacrolimus and mycophenolic acid concentrations in renal transplant recipients, with most concentrations and abbreviated AUCs falling within ±20% of conventional measures. Dosing recommendations differed on some occasions but the clinical impact was modest, suggesting home-based microsampling could support decentralised therapeutic drug monitoring with appropriate patient training.

Therapeutic drug monitoring of tacrolimus and mycophenolic acid in outpatient renal transplant recipients using a volumetric dried blood spot sampling device — Zwart et al., British journal of clinical pharmacology (paywalled) · source ↗

• blood
• dried
• dbs
• volumetric
• self-collection
• validation
• venous-agreement
• tdm
• immunosuppressants

Dried blood spot sampling demonstrated good agreement with venepuncture for tacrolimus and cyclosporine A, requiring no conversion formula, while creatinine needed a simple conversion factor. The method can replace conventional venous sampling for immunosuppressant monitoring in kidney transplant recipients, enabling home-based self-collection.

Clinical Validation of Simultaneous Analysis of Tacrolimus, Cyclosporine A, and Creatinine in Dried Blood Spots in Kidney Transplant Patients — Veenhof et al., Transplantation (paywalled) · source ↗

• blood
• dried
• dbs
• self-collection
• validation
• venous-agreement
• tdm
• immunosuppressants

The study validated a dried blood spot assay for five immunosuppressants on two LC-MS/MS systems, showing that haematocrit effects stayed within 15% across a clinically relevant range (0.23–0.48 l/l) without correction. Clinical validation confirmed that tacrolimus and cyclosporin A results from dried blood spots matched those from conventional whole blood, supporting home-based therapeutic drug monitoring without haematocrit adjustment.

Dried blood spot validation of five immunosuppressants, without hematocrit correction, on two LC-MS/MS systems — Koster et al., Bioanalysis (paywalled) · source ↗

• blood
• dried
• dbs
• self-collection
• validation
• venous-agreement
• tdm
• immunosuppressants
• haematocrit