After getting a kidney transplant, even very young patients must get frequent blood draws for therapeutic drug monitoring (TDM) to check the blood concentration level of the therapeutic drug, tacrolimus.
The immune system is inclined to attack foreign organisms introduced to the body, and the body interprets a new organ as foreign. Tacrolimus is a therapeutic drug administered orally to prevent rejection by inhibiting, or suppressing, the production of T-lymphocytes immune cells.
The dosage level of this immunosuppressant requires close monitoring to ensure it is within a narrow therapeutic range. Extremely high concentrations lead to toxicity. Low levels can cause organ rejection. Examining blood samples from patients receiving this drug help the healthcare providers adjust the dose to ensure efficacy and avoid toxicity.
Patient monitoring is also essential to keep an eye on creatinine levels in the blood, which indicate if the kidney is being accepted and functioning well. Research shows an effective renal transplant should have creatinine levels of 100-120 uL. Higher levels (for example, 25% more than the average level), are a sign of acute transplant rejection.
Regular monitoring of blood samples is critical to determine appropriate levels of each chemical. This is particularly important in young patients, whose bodies can be more sensitive.
Blood microsampling methods that provide a simple and precise way to collect blood are in high demand, particularly for younger patients who must get frequent blood draws. Techniques that replace venipuncture are becoming more popular, such as a finger-stick blood collection method that can still provide the proper volume of blood needed to determine pharmacokinetic parameters and correct quantities of drug concentrations.
A finger-stick blood draw involves collecting blood from a fingertip on a swab or filter paper. It is then dried and stored. New programs using these simpler and more convenient methods of blood collection have been launched to enable parents of young transplant patients to easily collect blood samples at home. One such program is the CountOnMe® program at Nottingham University Hospital, part of the NHS in the United Kingdom.
The CountOnMe program launched an initiative using Neoteryx® Mitra Microsample Collection Kits from Trajan Scientific and Medical to allow families to collect blood samples at home to assess tacrolimus and creatinine levels. Patients and families received the collection kit from their care providers at the hospital. They used the Mitra® microsampling devices in the kit to perform finger-stick blood sampling at home, and then returned the blood samples by mail for analysis in the lab.
The at-home Microsample Collection Kits provided a convenient and low-stress way of collecting blood samples from young patients in a comfortable, familiar environment.
Remote blood collection options are a very real advantage for children and other vulnerable patients who should avoid the exposure to contagions in facilities, especially during pandemics, such as the COVID-19 outbreak.
Ensure your hands are clean and dry.
Return the sample to the lab by placing the sealed specimen bag into the included envelope and drop the envelope in the nearest mailbox.