Calcineurin Inhibitor Determination in Whole Blood With the RXL Dimension Analyzer: A Useful Tool for Immunosuppressive Drug Monitoring

• Published in: Transplantation proceedings Vol. 41; no. 2; pp. 707 - 709
• Main Authors: Ventura, E, Bonardet, A, Pageaux, G.P, Mourad, G, Cristol, J.P
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Amsterdam Elsevier Inc 01-03-2009; Elsevier
• Subjects: Biological and medical sciences; Bone Marrow Transplantation - immunology; Calcineurin Inhibitors; Cyclosporine - blood; Cyclosporine - pharmacology; Cyclosporine - therapeutic use; Drug Monitoring - methods; Enzyme Multiplied Immunoassay Technique; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Heart Transplantation - immunology; Humans; Immunosuppressive Agents - blood; Immunosuppressive Agents - pharmacology; Immunosuppressive Agents - therapeutic use; Indicators and Reagents; Kidney Transplantation - immunology; Liver Transplantation - immunology; Medical sciences; Regression Analysis; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tacrolimus - blood; Tacrolimus - pharmacokinetics; Tacrolimus - therapeutic use; Tissue, organ and graft immunology; Calcineurin inhibitor; Transplantation; Dimension; Determination; Analyzer; Medicine; Whole blood; Therapeutic drug monitoring; Treatment; Surgery; Graft; Immunosuppressive agent; Tool
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2008.12.018

Abstract Routine monitoring of cyclosporine and tacrolimus levels is necessary to minimize adverse side effects and to ensure effective immunosuppression. The RXL Dimension apparatus conceived for ACMIA technologies is proposed to determine C0 and C2 cyclosporine levels and also tacrolimus levels in whole blood without any dilution or pretreatment using specific calibrators and Flex reagent cartridges (reagent stability: 72 hours for Neoral C0 and C2; 48 hours for tacrolimus). The assay ranges were between 25 to 500 ng/mL for C0; 350 to 2000 ng/mL for C2; and 1.2 to 30 ng/mL for tacrolimus. Within-run and between-day imprecision were <10% for cyclosporine. The coefficient of linearity was r2 = .998 for C0, C2, and tacrolimus. Moreover, for cyclosporine and tacrolimus assays, the time for the first result was 20 minutes. Cyclosporine (C0, n = 152; C2, n = 54) and tacrolimus (n = 70) ACMIA assays were compared with enzyme-multiplied immunoassay technique (EMIT) cyclosporine and tacrolimus assays (V-Twin, Siemens ex-Dade Behring Laboratories) among 276 transplant patients: 119 kidney, 67 liver, 28 heart, and 62 bone marrow transplantations. Values obtained with the ACMIA assay were highly correlated with the EMIT assay for CsA C0 levels (ACMIA = 1.04 EMIT - 9.32; r2 = .97); CsA C2 levels (ACMIA = 1.15 EMIT - 53.7; r2 = .94); and tacrolimus levels (ACMIA = 0.93 EMIT - 0.16; r2 = .93). In conclusion, the RXL Dimension analyzer is a useful tool for routine monitoring with a single method for C0 and C2 cyclosporine and tacrolimus level determinations in whole blood without any dilution or preanalytic treatment.