Clinical Application of Microvolume LC-MS/MS for Therapeutic Drug Monitoring of Immunosuppressants in Solid-Organ Transplant Recipients
Iwami et al.
The finding, in our words
A liquid-phase microsampling method using 2.8 µL of whole blood demonstrated strong correlation with conventional venous sampling for immunosuppressant monitoring in renal transplant recipients. This approach enables patient-centric therapeutic drug monitoring, reducing burden and supporting implementation in home-based, paediatric, and telemedicine settings.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
In lung and renal transplant recipients, VAMS sampling with LC-MS/MS quantification of mycophenolic acid and tacrolimus showed good linearity and accuracy, and with a haematocrit-adjusted conversion formula achieved clinical agreement in most samples; tacrolimus did not require haematocrit correction. The approach is virtually painless and enables richer sampling for more accurate drug exposure estimates, supporting decentralised therapeutic drug monitoring.
Juan et al., Journal of pharmacy & pharmaceutical sciences : a publication of the Canadian Society for Pharmaceutical Sciences, Societe canadienne des sciences pharmaceutiques · source ↗
This study validated a method for monitoring mycophenolic acid in paediatric patients, demonstrating that quantitative dried plasma spots achieved close agreement with venous plasma. Quantitative dried blood spots showed significant haematocrit-related bias, making the plasma-based format more suitable for decentralised monitoring.
Kocur et al., Journal of chromatography. B, Analytical technologies in the biomedical and life sciences (paywalled) · source ↗
Fingerstick capillary sampling showed strong agreement with venous sampling for mycophenolic acid, tacrolimus and cyclosporine A, with acceptable bias and improved agreement for mycophenolic acid after haematocrit correction. This minimally invasive approach may reduce procedural burden and support outpatient or home based therapeutic drug monitoring in children.
In matched clinical samples from rheumatoid arthritis, VAMS and DBS showed strong agreement for methotrexate polyglutamates (slopes 0.95-1.07; bias within -4.21% to 0.36%; SRCC ≥ 0.969), with up to 100% of total MTXPG results within ±20% limits; capillary microsampling agreed closely with whole blood but differed from red blood cells, indicating matrix-specific differences that must be accounted for when interpreting against RBC-based reference values.
Kocur et al., International journal of molecular sciences · source ↗
A validated LC-MS/MS method for everolimus using Mitra and Capitainer devices found excellent agreement between capillary microsamples and venous whole blood in 33 adult transplant recipients. The results showed high accuracy and negligible haematocrit effects, supporting the use of microsampling for decentralised therapeutic drug monitoring.