Dried Blood Spot for CXCL-10 and Tacrolimus: Integrated Non-Invasive Monitoring to Guide Personalized Treatment in Adult Kidney Transplant Recipients
Millán et al.
The finding, in our words
This study validated a dried blood spot method for tacrolimus monitoring and demonstrated agreement with venous whole blood measurements in kidney transplant recipients. It also found that dried blood spot analysis of the biomarker CXCL-10 was elevated in patients experiencing rejection or infection, supporting its use for decentralised monitoring.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
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.
A validated offline SPE-LC-MS/MS method using the Mitra microsampling device successfully quantified tacrolimus, cyclosporine A, tryptophan, kynurenine, and creatinine simultaneously. The method met EMA and FDA criteria, showing agreement between capillary and venous sampling, which could facilitate decentralised therapeutic drug monitoring and transplant follow-up through patient self-collection.
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.
Automated dried blood spot analysis achieved clinical and analytical acceptance criteria for tacrolimus, sirolimus, everolimus and cyclosporin A after haematocrit correction. This validates a method that could enable decentralised, patient-centric therapeutic drug monitoring for transplant recipients.
In adult kidney transplant patients, fingerprick VAMS and dried blood spot microsampling achieved accurate simultaneous measurement of tacrolimus, mycophenolic acid, and prednisolone compared with venepuncture. The authors noted an overall preference for VAMS over conventional dried blood spots.