Immunosuppressive Drug Monitoring: Limitations of Immunoassays and the Application of Liquid Chromatography Mass Spectrometry

摘要: Immunosuppressive drug monitoring is required for optimizing individualized therapeutic effectiveness and minimizing serious adverse events. To accomplish this, precise robust analytical methods are quantitating blood concentrations of cyclosporine, tacrolimus, sirolimus, mycophenolic acid and, more recently, everolimus. The majority laboratories in the United States measure immunosuppressive drugs by immunoassay, despite significant metabolite cross-reactivity that can be extremely variable, depending on organ type post-transplant time. Liquid chromatography separation coupled with mass spectrometry detection offer unparalleled sensitivity, specificity versatility drugs, but typically only utilized large laboratories. Immunoassays popular because they automated, have low start-up costs, easy to perform without need specially trained technologists. In view increasing cost immunoassay reagents, liquid systems rapidly becoming a good investment drugs.