When using immunosuppressant drugs as an organ transplant recipient, it is crucial to effectively and consistently monitor drug levels. This requires therapeutic drug monitoring and an understanding of requirements and best practices for therapeutic drug monitoring in the laboratory.

Therapeutic drug monitoring (TDM) for immunosuppressive drugs (ISPs) is a critical component of post-tissue and organ transplantation therapy. This is because ISP drugs have high intra- and inter-subject variability and a narrow therapeutic window. Initially, quantitative analyses of ISPs such as sirolimus, cyclosporine A, tacrolimus, and everolimus used whole blood specimens.

When administering immunosuppressants, clinicians need to individualize a patient’s drug therapy. The goal is to attain an optimal balance between therapeutic efficacy and the probability of adverse effects. Patients present varying pharmacodynamics and pharmacokinetics, so achieving this goal can be challenging.

For many organ transplant patients, immunosuppressant monitoring is a fact of life. But that does not mean that it cannot be significantly improved. For proof, look no further than the remote blood sampling capabilities provided by Mitra^® microsampling devices, driven by Volumetric Absorptive Microsampling (VAMS^®) technology.

At the 2019 meeting of the American Transplant Congress, held this year in Boston, scientists from the Oslo University Hospital, Rikshospitalet presented exciting findings regarding more patient-centered AUC-monitoring of tacrolimus, a cornerstone immunosppressant, using blood microsampling systems driven by Mitra^® devices and Volumetric Absorptive Microsampling (VAMS™) technology. Researcher and PhD student Marte Theie Gustavsen was on hand to give the presentation and made time to answer a few questions.

Capillary blood microsampling is a technique that has made collection and analysis of small, exact volumes of liquid matrices much simpler. Through capillary blood microsampling, tacrolimus monitoring has potentially become more patient-centered. Here's why you should consider blood microsampling when it comes to tacrolimus monitoring.