Review & Monography

Overview of dried blood spot method and its application in therapeutic drug monitoring of immunosuppressants in organ transplantation*

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  • 1. Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China;
    2. Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan 430022, China;
    3. College of Pharmacy, Chongqing Medical University, Chongqing 400016, China

Received date: 2022-12-08

  Online published: 2024-06-24

Abstract

Immunosuppressants are widely used after organ transplantation, which are characterized by narrow therapeutic window and large inter-variability in pharmacokinetics. Therefore, it is necessary to carry out therapeutic drug monitoring (TDM) to guide individualized therapy. With the development of mass spectrometry and microsampling techniques, dried blood spot (DBS) method has been gradually applied in the field of TDM, especially in monitoring immunosuppressants. This paper reviews the application of DBS method and its research in immunosuppressants TDM for organ transplantation patients, and may provide reference for the development and clinical application of this method.

Cite this article

GONG Zhu-jun, CHEN He-fen, YUAN Yong-hua, HAN Yong, ZHOU Hong . Overview of dried blood spot method and its application in therapeutic drug monitoring of immunosuppressants in organ transplantation*[J]. Chinese Journal of Pharmaceutical Analysis, 2023 , 43(8) : 1277 -1283 . DOI: 10.16155/j.0254-1793.2023.08.02

References

[1] PARLAKPINAR H, GUNATA M. Transplantation and immunosuppression: a review of novel transplant-related immunosuppressant drugs[J].Immunopharmacol Immunotoxicol, 2021, 43(6):651
[2] KALT DA. Tacrolimus: a review of laboratory detection methods and indications for use[J].Lab Med, 2017, 48(4):e62
[3] ZAKARIA R, ALLEN KJ, KOPLIN JJ, et al. Advantages and challenges of dried blood spot analysis by mass spectrometry across the total testing process[J].EJIFCC, 2016, 27(4):288
[4] GUTHRIE R, SUSI A. A simple phenylalanine method for detecting phenylketonuria in large populations of newborn infants[J].Pediatrics, 1963, 32: 338
[5] ENDERLE Y, FOERSTER K, BURHENNE J. Clinical feasibility of dried blood spots: analytics, validation, and applications[J].J Pharm Biomed Anal, 2016, 130: 231
[6] WILHELM AJ, DEN BURGER JC, SWART EL. Therapeutic drug monitoring by dried blood spot: progress to date and future directions[J].Clin Pharmacokinet, 2014, 53(11):961
[7] 程晓亮. 干血斑法在血药浓度监测中的应用[C]//第八届全国治疗药物监测学术年会. 郑州, 2018
CHENG XL. Application of dried blood spots in therapeutic drug monitoring[C]// The 8th national annual conference on therapeutic drug monitoring. Zhengzhou, 2018
[8] KLAK A, PAUWELS S, VERMEERSCH P. Preanalytical considerations in therapeutic drug monitoring of immunosuppressants with dried blood spots[J].Diagnosis(Berl), 2019, 6(1):57
[9] CAPIAU S, VEENHOF H, KOSTER RA, et al. Official international association for therapeutic drug monitoring and clinical toxicology guideline: development and validation of dried blood spot-based methods for therapeutic drug monitoring[J].Ther Drug Monit, 2019, 41(4):409
[10] WAGNER M, TONOLI D, VARESIO E, et al. The use of mass spectrometry to analyze dried blood spots[J].Mass Spectrom Rev, 2016, 35(3):361
[11] KOSTER RA, ALFFENAAR JW, BOTMA R, et al. The relation of the number of hydrogen-bond acceptors with recoveries of immunosuppressants in DBS analysis[J].Bioanalysis, 2015, 7(14):1717
[12] KOSTER RA, BOTMA R, GREIJDANUS B, et al. The performance of five different dried blood spot cards for the analysis of six immunosuppressants[J].Bioanalysis, 2015, 7(10):1225
[13] LEI B, PROW TW. A review of microsampling techniques and their social impact[J].Biomed Microdevices, 2019, 21(4):81
[14] VEENHOF H, KOSTER RA, ALFFENAAR JC, et al. Clinical application of a dried blood spot assay for sirolimus and everolimus in transplant patients[J].Clin Chem Lab Med, 2019, 57(12):1854
[15] ZWART TC, GOKOEL SRM, VAN DER BOOG PJM, et al. Therapeutic drug monitoring of tacrolimus and mycophenolic acid in outpatient renal transplant recipients using a volumetric dried blood spot sampling device[J].Br J Clin Pharmacol, 2018, 84(12):2889
[16] BRESSÁN IG, GIMÉNEZ MI, LLESUY SF. Validation of a simple liquid chromatography coupled to tandem mass spectrometry method for the simultaneous determination of tacrolimus, sirolimus, everolimus and cyclosporin A in dried matrix on paper discs[J].J Mass Spectrom Adv Clin Lab, 2021, 19: 7
[17] CAPIAU S, STOVE VV, LAMBERT WE, et al. Prediction of the hematocrit of dried blood spots via potassium measurement on a routine clinical chemistry analyzer[J].Anal Chem, 2013, 85(1):404
[18] ZIMMERMANN S, AGHAI F, SCHILLING B, et al. Volumetric absorptive microsampling (VAMS) for the quantification of ten kinase inhibitors and determination of their in vitro VAMS-to-plasma ratio[J].J Pharm Biomed Anal, 2022, 211: 114623
[19] TRON C, FERRAND-SORRE MJ, QUERZERHO-RAGUIDEAU J, et al. Volumetric absorptive microsampling for the quantification of tacrolimus in capillary blood by high performance liquid chromatography-tandem mass spectrometry[J].J Chromatogr B Analyt Technol Biomed Life Sci, 2021, 1165: 122521
[20] VEENHOF H, KOSTER RA, JUNIER L, et al. Volumetric absorptive microsampling and dried blood spot microsampling vs. conventional venous sampling for tacrolimus trough concentration monitoring[J].Clin Chem Lab Med, 2020, 58(10):1687
[21] PANIAGUA-GONZÁLEZ L, LENDOIRO E, OTERO-ANTÓN E, et al. Comparison of conventional dried blood spots and volumetric absorptive microsampling for tacrolimus and mycophenolic acid determination[J].J Pharm Biomed Anal, 2022, 208: 114443
[22] LEUTHOLD LA, HEUDI O, DÉGLON J, et al. New microfluidic-based sampling procedure for overcoming the hematocrit problem associated with dried blood spot analysis[J].Anal Chem, 2015, 87(4):2068
[23] AL-UZRI A, FREEMAN K A, WADE J, et al. Longitudinal study on the use of dried blood spots for home monitoring in children after kidney transplantation[J].Pediatr Transplant, 2017, 21(6):e12983
[24] MARTIAL LC, HOOGTANDERS K, SCHREUDER MF, et al. Dried blood spot sampling for tacrolimus and mycophenolic acid in children: analytical and clinical validation[J].Ther Drug Monit, 2017, 39(4):412
[25] VEENHOF H, VAN BOVEN JFM, VAN DER VOORT A, et al. Effects, costs and implementation of monitoring kidney transplant patients' tacrolimus levels with dried blood spot sampling: a randomized controlled hybrid implementation trial[J].Br J Clin Pharmacol, 2020, 86(7):1357
[26] MCCLENDON-WEARY B, PUTNICK DL, ROBINSON S, et al. Little to give, much to gain-what can you do with a dried blood spot?[J].Curr Environ Health Rep, 2020, 7(3):211
[27] KOSTER RA, ALFFENAAR JW, GREIJDANUS B, et al. Fast LC-MS/MS analysis of tacrolimus, sirolimus, everolimus and cyclosporin a in dried blood spots and the influence of the hematocrit and immunosuppressant concentration on recovery[J].Talanta, 2013, 115: 47
[28] VEENHOF H, KOSTER RA, ALFFENAAR JC, et al. Clinical validation of simultaneous analysis of tacrolimus, cyclosporine A, and creatinine in dried blood spots in kidney transplant patients[J].Transplantation, 2017, 101(7):1727
[29] HINCHLIFFE E, ADAWAY J, FILDES J, et al. Therapeutic drug monitoring of ciclosporin A and tacrolimus in heart lung transplant patients using dried blood spots[J].Ann Clin Biochem, 2014, 51(Pt 1):106
[30] HINCHLIFFE E, ADAWAY JE, KEEVIL BG. Simultaneous measurement of cyclosporin A and tacrolimus from dried blood spots by ultra high performance liquid chromatography tandem mass spectrometry[J].J Chromatogr B Analyt Technol Biomed Life Sci, 2012, 883-884: 102
[31] ARPINI J, ANTUNES MV, PACHECO LS, et al. Clinical evaluation of a dried blood spot method for determination of mycophenolic acid in renal transplant patients[J].Clin Biochem, 2013, 46(18):1905
[32] WILHELM AJ, den BURGER JC, VOS RM, et al. Analysis of cyclosporin A in dried blood spots using liquid chromatography tandem mass spectrometry[J].J Chromatogr B Analyt Technol Biomed Life Sci, 2009,877(14-15):1595
[33] WILHELM A J, KLIJN A, den BURGER JC, et al. Clinical validation of dried blood spot sampling in therapeutic drug monitoring of ciclosporin A in allogeneic stem cell transplant recipients: direct comparison between capillary and venous sampling[J].Ther Drug Monit, 2013, 35(1):92
[34] KOOP DR, BLEYLE LA, MUNAR M, et al. Analysis of tacrolimus and creatinine from a single dried blood spot using liquid chromatography tandem mass spectrometry[J].J Chromatogr B Analyt Technol Biomed Life Sci, 2013, 926: 54
[35] DICKERSON JA, SINKEY M, JACOT K, et al. Tacrolimus and sirolimus in capillary dried blood spots allows for remote monitoring[J].Pediatr Transplant, 2015, 19(1):101
[36] SADILKOVA K, BUSBY B, DICKERSON JA, et al. Clinical validation and implementation of a multiplexed immunosuppressant assay in dried blood spots by LC-MS/MS[J].Clin Chim Acta, 2013,421: 152
[37] HOOGTANDERS K, VAN DER HEIJDEN J, CHRISTIAANS M, et al. Therapeutic drug monitoring of tacrolimus with the dried blood spot method[J].J Pharm Biomed Anal, 2007, 44(3):658
[38] IBOSHI H, YAMAGUCHI H, SUZUKI H, et al. Development of a liquid chromatography-tandem mass spectrometric method for quantification of mycophenolic acid and its glucuronides in dried blood spot samples[J].Ther Drug Monit, 2017, 39(6):648
[39] IACUZZI V, POSOCCO B, ZANCHETTA M, et al. Dried blood spot technique applied in therapeutic drug monitoring of anticancer drugs: a review on conversion methods to correlate plasma and dried blood spot concentrations[J].Pharm Res, 2021, 38(5):759
[40] MARTIAL LC, BIEWENGA M, RUIJTER BN, et al. Population pharmacokinetics and genetics of oral meltdose tacrolimus (envarsus) in stable adult liver transplant recipients[J].Br J Clin Pharmacol, 2021, 87(11):4262
[41] STIFFT F, STOLK LM, UNDRE N, et al. Lower variability in 24-hour exposure during once-daily compared to twice-daily tacrolimus formulation in kidney transplantation[J].Transplantation, 2014, 97(7):775
[42] van BOEKEL GA, AARNOUTSE RE, HOOGTANDERS KE, et al. Delayed trough level measurement with the use of prolonged-release tacrolimus[J].Transpl Int, 2015,28(3):314
[43] ALMARDINI R, TAYBEH EO, ALSOUS MM, et al. A multiple methods approach to determine adherence with prescribed mycophenolate in children with kidney transplant[J].Br J Clin Pharmacol, 2019, 85(7):1434
[44] CHEUNG CY, VAN DER HEIJDEN J, HOOGTANDERS K, et al. Dried blood spot measurement: application in tacrolimus monitoring using limited sampling strategy and abbreviated AUC estimation[J].Transpl Int, 2008, 21(2):140
[45] VAN BOEKEL GA, DONDERS AR, HOOGTANDERS KE, et al. Limited sampling strategy for prolonged-release tacrolimus in renal transplant patients by use of the dried blood spot technique[J].Eur J Clin Pharmacol, 2015, 71(7):811
[46] LEINO AD, KING EC, JIANG W, et al. Assessment of tacrolimus intrapatient variability in stable adherent transplant recipients: establishing baseline values[J].Am J Transplant, 2019, 19(5):1410
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