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OpenSampling

2022 · Int. J. Molecular Sciences · open access

Volumetric Absorptive Microsampling in Therapeutic Drug Monitoring of Immunosuppressive Drugs — From Sampling and Analytical Issues to Clinical Application

Kocur & Pawiński

The finding, in our words

This review shows that patient-centric Mitra microsampling devices accurately collect fixed blood volumes for immunosuppressant monitoring, reducing haematocrit bias compared to classic dried blood spots. While ideal for paediatric adherence, wider decentralised adoption requires further multicentre validation and cross-laboratory harmonisation to address current analytical and cost limitations.

A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.

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  1. 2024

    The study validated a VAMS-based LC-MS/MS method for measuring sirolimus levels, showing it was clinically equivalent to the standard whole blood method and suitable for therapeutic drug monitoring in paediatric transplant patients, supporting the use of decentralised microsampling for this purpose.

    Personalization of pharmacotherapy with sirolimus based on volumetric absorptive microsampling (VAMS) in pediatric renal transplant recipients-from LC-MS/MS method validation to clinical applicationKocur et al., Pharmacological reports : PR · source ↗

    • vams
    • venous-agreement
    • neoteryx-mitra
    • blood
    • tdm
    • haematocrit
    • dried
    • capillary
    • pediatric
    • immunosuppressants
    • validation
  2. 2023

    A study of 50 paediatric renal transplant recipients found that a validated VAMS LC-MS/MS method for tacrolimus showed high correlation with the reference method over 0.5–60 ng/mL, with minimal haematocrit effect.

    Therapeutic Drug Monitoring of Tacrolimus Based on VAMS in Renal Transplant Pediatric Recipients — LC-MS/MS Method, Hematocrit Effect, and Clinical ApplicationKocur et al., Pharmaceutics · source ↗

    • vams
    • venous-agreement
    • neoteryx-mitra
    • blood
    • tdm
    • haematocrit
    • dried
    • capillary
    • pediatric
    • immunosuppressants
    • validation
  3. 2026

    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.

    Evaluation of hematocrit-adjusted conversion strategies for mycophenolic acid and tacrolimus monitoring using volumetric absorptive microsampling in lung and renal transplant recipientsJuan et al., Journal of pharmacy & pharmaceutical sciences : a publication of the Canadian Society for Pharmaceutical Sciences, Societe canadienne des sciences pharmaceutiques · source ↗

    • blood
    • dried
    • vams
    • neoteryx-mitra
    • validation
    • venous-agreement
    • tdm
    • immunosuppressants
    • haematocrit
  4. 2026

    The study developed and validated a rapid LC-MS/MS method for quantifying cefazolin in capillary whole blood collected via VAMS, plasma, and plasma ultrafiltrate, showing robust performance across matrices and successful application in a pediatric pilot cohort for therapeutic drug monitoring.

    Rapid, robust LC-MS/MS quantification of cefazolin in whole blood microsamples, plasma, and plasma ultrafiltrate: Analytical method validation and preliminary clinical application in pediatric populationKocur et al., Clinica chimica acta; international journal of clinical chemistry (paywalled) · source ↗

    • vams
    • neoteryx-mitra
    • blood
    • tdm
    • haematocrit
    • dried
    • antimicrobials
    • capillary
    • pediatric
    • validation
  5. 2025

    Dried saliva collected with the Mitra device correlated strongly with wet saliva but poorly with plasma unbound and total concentrations, indicating it is not a reliable substitute for plasma in routine therapeutic drug monitoring of mycophenolic acid and its glucuronide metabolite. Capillary blood collected via VAMS remains a promising alternative for long term monitoring in paediatric patients.

    Volumetric Absorptive Microsampling of Saliva for Pharmacokinetic Evaluation of Mycophenolic Acid and Its Glucuronide Metabolite in Pediatric Renal Transplant Recipients: Bioanalytical Method Validation and Clinical Feasibility EvaluationKocur et al., Pharmaceuticals · source ↗

    • blood
    • saliva
    • dried
    • capillary
    • vams
    • neoteryx-mitra
    • validation
    • pediatric
    • tdm
    • immunosuppressants