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Journal of Transplantation
Volume 2010 (2010), Article ID 201918, 6 pages
http://dx.doi.org/10.1155/2010/201918
Clinical Study

Potential of Dried Blood Self-Sampling for Cyclosporine Monitoring in Transplant Outpatients

1Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, 04103 Leipzig, Germany
2Surgical Clinic and Policlinic II, University Hospital Leipzig, 04103 Leipzig, Germany

Received 8 February 2010; Revised 11 April 2010; Accepted 15 April 2010

Academic Editor: Edward H. Cole

Copyright © 2010 Alexander Benedikt Leichtle et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Close therapeutic drug monitoring of Cyclosporine (CsA) in transplant outpatients is a favourable procedure to maintain the long-term blood drug levels within their respective narrow therapeutic ranges. Compared to basal levels ( ), CsA peak levels ( ) are more predictive for transplant rejection. However, the application of levels is hampered by the precise time of blood sampling and the need of qualified personnel. Therefore, we evaluated a new self-obtained blood sampling in transplant outpatients using dried capillary and venous blood samples and compared the CsA levels, stability, and clinical practicability of the different procedures. Methods. 55 solid organ transplant recipients were instructed tousesingle-handed sampling of each 50 L capillary blood and dried blood spots by finger prick using standard finger prick devices. We used standardized EDTA-coated capillary blood collection systems and standardized filter paper WS 903. CsA was determined by LC-MS/MS. The patients and technicians also answered a questionnaire on the procedure and sample quality. Results. The and levels from capillary blood collection systems ( [ng/mL]: ; : ) and capillary dried blood ( [ng/mL]: ; : ) significantly correlated with the drug levels of the venous blood samples ( [ng/mL]: ; : ). The correlation at was = 0.749, and = 0.432; at = 0.861 and = 0.711. The patients preferred the dried blood sampling because of the more simple and less painful procedure. Additionally, the sample quality of self-obtained dried blood spots for LC-MS/MS analytics was superior to the respective capillary blood samples. Conclusions. self-obtained dried blood sampling can easily be performed by transplant outpatients and is therefore suitable and cost-effective for close therapeutic drug monitoring.