Clinical performance of volumetric finger-prick sampling for the monitoring of tacrolimus, creatinine and haemoglobin in kidney transplant recipients

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.

Therapeutic Drug Monitoring of Everolimus Using Volumetric Absorptive Microsampling and Quantitative Dried Blood Spot Methods with LC-MS/MS in Adult Solid Organ Transplant Recipients: An Analytical and Clinical Comparative Study — Kocur et al., Molecules · source ↗

• vams
• venous-agreement
• neoteryx-mitra
• blood
• qdbs
• tdm
• haematocrit
• dried
• capillary
• immunosuppressants
• validation

Microsampling, particularly VAMS and quantitative DBS, can enable patient-centric therapeutic drug monitoring of immunosuppressants after transplantation, allowing home self-sampling and long-term monitoring when patients live far from transplant centres. These volumetric dried formats have largely overcome the haematocrit effect and sample heterogeneity that limit conventional dried blood spots.

Microsampling techniques and patient-centric therapeutic drug monitoring of immunosuppressants — Kocur & Pawiński, Bioanalysis (paywalled) · source ↗

• vams
• volumetric
• venous-agreement
• blood
• qdbs
• tdm
• self-collection
• haematocrit
• dried
• capillary
• immunosuppressants

Deprez et al. validated LC‑MS/MS methods for four immunosuppressants and creatinine from a single 10 μL quantitative dried blood spot. With biases under 10 % and CVs below 8 %, the approach enables accurate patient‑centric therapeutic drug monitoring from capillary blood at home, mitigating the haematocrit effect through volumetric collection.

Liquid chromatography-tandem mass spectrometry for therapeutic drug monitoring of immunosuppressants and creatinine from a single dried blood spot using the Capitainer® qDBS device — Deprez et al., Analytica chimica acta (paywalled) · source ↗

• volumetric
• blood
• qdbs
• tdm
• self-collection
• haematocrit
• dried
• capillary
• 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

The Mitra microsampling device showed high clinical concordance with venous blood for tacrolimus (89%) and cyclosporin A (98%) monitoring, with inter- and intra-precision within 11.5% CV and samples stable for up to 7 days at room temperature. Transplant patients preferred collecting capillary samples at home for their immunosuppressant monitoring, supporting decentralised TDM.

Volumetric Microsampling of Capillary Blood Spot vs Whole Blood Sampling for Therapeutic Drug Monitoring of Tacrolimus and Cyclosporin A: Accuracy and Patient Satisfaction — Mbughuni et al., The journal of applied laboratory medicine (paywalled) · source ↗

• blood
• capillary
• vams
• volumetric
• neoteryx-mitra
• validation
• venous-agreement
• acceptability
• tdm
• immunosuppressants