Home fingerprick sampling for immunosuppressant drug monitoring in pediatric renal transplant patients

Philip D Acott

This article has no abstract so we have provided the first paragraph of the full text.

A previous study¹ cited by Webb et al. confirmed the utility of fingerprick capillary sampling and HPLC T-MS for monitoring levels of another calcineurin inhibitor—ciclosporin—in heart and lung transplant recipients, with similar results to the present report. As HPLC T-MS becomes available in more healthcare facilities, its utilization can be expected to increase, which will probably increase the efficiency of fingerprick blood collection for this purpose. The stability of tacrolimus for up to 1 month at 4 °C allows samples to be pooled at home or in clinical facilities before being sent for analysis, although it is important for data on tacrolimus levels to be obtained within a shorter timeframe to allow timely dose correction and to ensure allograft stability. Similarly, the stability of tacrolimus for up to 3 days at 40 °C makes it possible for samples to be transported between healthcare institutions and from patients' homes to analytical laboratories. Although tacrolimus levels in fingerprick blood samples assessed by HPLC T-MS are on average 0.58 ng/ml lower than levels obtained with IMx^® assay of venous samples, this difference could easily be adjusted for in clinical practice by using the regression formula proposed by Webb and colleagues.

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