Dried blood microsampling-assisted therapeutic drug monitoring of immunosuppressants: An overview
Deprez & Stove
The finding, in our words
This review surveys published LC-MS/MS methods that use dried blood microsampling for therapeutic drug monitoring of immunosuppressants in transplantation, chemotherapy and autoimmune disease, finding that volumetric dried blood samples can replace conventional venous draws for home sampling and improve patient quality of life. The authors discuss pre-analytical considerations, clinical applicability, cost-effectiveness, harmonisation gaps and patient perception, concluding that obstacles to routine clinical implementation remain despite growing methodological maturity.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
A 2025 review maps 28 microsampling devices, from dried spots and volumetric absorptive tips to upper-arm liquid capillary collectors, and names what a laboratory must control before their results are used: the haematocrit effect in non-volumetric dried samples, interstitial fluid from finger milking, volume, haemolysis and transport stability. Regulators on both sides of the Atlantic ask for the same two things, a device the patient can use safely and a sample fit for the test.
The authors observe that self-sampling devices for capillary blood are gaining traction as a patient-preferred alternative to venous collection, with one centre reporting a 15 percent reduction in laboratory test volumes when local collection was offered. They argue that successful integration into total laboratory automation requires addressing cost, transport regulations and sample volume adequacy while ensuring robust device design and seamless workflow compatibility.
Poland & Cobbaert, Clinical chemistry and laboratory medicine (paywalled) · source ↗
This systematic review of 67 studies involving 34,739 kidney disease patients found dried blood microsampling was mainly used for immunosuppressant therapeutic drug monitoring and kidney function assessment. The approach offered cost savings, was preferred by patients for home self-collection, and provides a patient-centric opportunity to upscale longitudinal sampling and reduce participation bias in decentralised kidney disease research.
Lamond et al., Journal of clinical laboratory analysis · source ↗
This review found that volumetric microsampling devices, such as Mitra, HemaPEN, HemaXis DB10, and Tasso-M20, overcome haematocrit bias, whilst Telimmune plasma separation cards enable direct plasma collection without centrifugation. These technologies support patient-centric, decentralised sampling, though the authors note that clinical validation remains limited across different drugs and patient populations.
Huhn & Scherf-Clavel, Therapeutic drug monitoring (paywalled) · source ↗
A systematic review found mixed economic evidence for microsampling in therapeutic drug monitoring; one study reported no cost reduction with DBS home-sampling, €688 versus €676, whilst another predicted savings up to 61%. The authors caution that more work is required to assess costs alongside clinical outcomes and optimise logistics for decentralised implementation.
Carland et al., British Journal of Clinical Pharmacology (paywalled) · source ↗