We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Clinical application of a dried blood spot assay for sirolimus and everolimus in transplant patients.
- Authors
Veenhof, Herman; Koster, Remco A.; Alffenaar, Jan-Willem C.; van den Berg, Aad P.; de Groot, Marco R.; Verschuuren, Erik A.M.; Berger, Stefan P.; Bakker, Stephan J.L.; Touw, Daan J.
- Abstract
Background: Monitoring of immunosuppressive drugs such as everolimus and sirolimus is important in allograft rejection prevention in transplant patients. Dried blood spots (DBS) sampling gives patients the opportunity to sample a drop of blood from a fingerprick at home, which can be sent to the laboratory by mail. Methods: A total of 39 sirolimus and 44 everolimus paired fingerprick DBS and whole blood (WB) samples were obtained from 60 adult transplant patients for method comparison using Passing-Bablok regression. Bias was assessed using Bland-Altman. Two validation limits were pre-defined: limits of analytical acceptance were set at >67% of all paired samples within 20% of the mean of both samples and limits of clinical relevance were set in a multidisciplinary team at >80% of all paired samples within 15% of the mean of both samples. Results: For both sirolimus and everolimus, Passing-Bablok regression showed no differences between WB and DBS with slopes of 0.86 (95% CI slope, 0.72–1.02) and 0.96 (95% CI 0.84–1.06), respectively. Only everolimus showed a significant constant bias of 4%. For both sirolimus and everolimus, limits of analytical acceptance were met (76.9% and 81.8%, respectively), but limits or clinical relevance were not met (77.3% and 61.5%, respectively). Conclusions: Because pre-defined limits of clinical relevance were not met, this DBS sampling method for sirolimus and everolimus cannot replace WB sampling in our center at this time. However, if the clinical setting is compatible with less strict limits for clinical relevance, this DBS method is suitable for clinical application.
- Subjects
EVEROLIMUS; RAPAMYCIN; IMMUNOSUPPRESSIVE agents; GRAFT rejection; DRUG monitoring; TRANSPLANTATION of organs, tissues, etc.
- Publication
Clinical Chemistry & Laboratory Medicine, 2019, Vol 57, Issue 12, p1854
- ISSN
1434-6621
- Publication type
Article
- DOI
10.1515/cclm-2019-0053