2023 · J. Mass Spectrometry and Advances in the Clinical Lab · open access
VAMS and parallel-reaction-monitoring mass spectrometry for tacrolimus trough measurements at home in paediatric heart-transplant patients
Zhao et al.
The finding, in our words
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.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
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.
Dried VAMS and DBS samples collected at home and analysed after a median of three days showed poor agreement with standard venous or capillary blood for HbA1c monitoring. In contrast, wet VAMS samples analysed immediately demonstrated excellent agreement, indicating that sample drying and delayed analysis compromise reliability for decentralised HbA1c measurement.
In AML and CLL, 91% of VAMS venetoclax results fell within 20% of plasma after individualised haematocrit correction; in home sampling, 18 of 21 patients self-sampled independently and 76% of returned samples were analysable, which shows home microsampling is workable, though the authors ask for multicentre validation.
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.
The study found that quantitative dried blood spot sampling provided high clinical agreement for tacrolimus and creatinine monitoring, with patients rating the self-collection devices as user-friendly. These results support the feasibility of decentralised therapeutic drug monitoring for immunosuppressants.