Cyclosporine - EDTA
Test Code
C99
Also Known As
ALSO KNOWN AS:
* Cyclosporine Blood Level
* Cyclosporine A Trough Level
* Cyclosporine TDM (Therapeutic Drug Monitoring)
* Cyclosporine by LC-MS/MS
* Cyclosporin Level
* Cyclosporin A Blood Concentration
* Sandimmune Level
* Neoral Level
Test Parameters Included
No data available
Department
CLINICAL BIOCHEMISTRY
Methodology
LC-MS (Liquid Chromatography-Mass Spectrometry)
LC-MS/MS (Liquid Chromatography-Tandem Mass Spectrometry) is the gold standard for measuring cyclosporine levels due to its high specificity, sensitivity, and accuracy. This advanced method is superior to older immunoassay methods because it is not affected by cross-reactivity with cyclosporine metabolites. The process involves:
* Sample Preparation: The whole blood sample is pretreated to extract the cyclosporine from the blood cells and proteins. This often involves a protein precipitation step. An internal standard (e.g., a deuterated cyclosporine molecule) is added to the sample to ensure accuracy and precision.
* Liquid Chromatography (LC): The prepared sample is injected into a liquid chromatography column. The column separates the cyclosporine from other compounds in the blood based on their chemical properties. The cyclosporine molecule elutes from the column at a specific, predictable time.
* Mass Spectrometry (MS/MS): As the cyclosporine elutes from the column, it enters the mass spectrometer.
* Ionization: The molecules are ionized (given an electrical charge).
* Mass Analysis: The mass spectrometer measures the mass-to-charge ratio of the ionized molecules. Tandem mass spectrometry (MS/MS) takes this a step further by fragmenting the cyclosporine molecules and then measuring the mass of the resulting fragments. This provides an extremely specific and sensitive detection method.
* Quantification: The concentration of cyclosporine is determined by comparing the signal intensity of the detected cyclosporine to that of the internal standard and a calibration curve. This provides a precise quantitative result.
Sample Required
WB EDTA (Whole Blood in an EDTA Tube) - 3 ML
* Collection: Blood is collected via venipuncture into a lavender-top tube containing EDTA (ethylenediaminetetraacetic acid) as an anticoagulant.
* Volume: A minimum of 3 mL of whole blood is typically required.
* Why Whole Blood? Approximately 80% of cyclosporine in the blood is sequestered in red blood cells. Therefore, whole blood is the preferred specimen type for an accurate measurement of the total drug concentration, which is essential for therapeutic drug monitoring.
* Processing: The sample should not be centrifuged. It should be sent to the laboratory as whole blood in the original tube.
* Storage and Transport: The sample should be transported to the lab promptly. It is stable at refrigerated (2-8°C) and ambient temperatures for several days. Do not freeze the sample unless specified by the lab, as some laboratories do not accept frozen samples.
Preparation
Patient preparation is critical for accurate and clinically meaningful results: * Timing of Blood Collection: The most important preparation is the timing of the blood draw. The sample must be a troug... Read more
Schedule Report
72 Hours
Emergency Report
Yes
Frequently Asked Questions
FREQUENTLY ASKED QUESTIONS (FAQs) - Cyclosporine - EDTA:<br/> Q: Why is it important to test cyclosporine levels?<br/> A: Cyclosporine has a narrow therapeutic window, meaning that levels must be kep... Read more
Test Description
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