Therapeutic Drug Monitoring of Tacrolimus Based on Volumetric Absorptive Microsampling Technique (VAMS) in Renal Transplant Pediatric Recipients-LC-MS/MS Method Development, Hematocrit Effect Evaluation, and Clinical Application.

Content Provider	Europe PMC
Author	Kocur, Arkadiusz Marszałek, Dorota Rubik, Jacek Czajkowska, Agnieszka Pawiński, Tomasz
Editor	Liang, Dong
Copyright Year	2023
Abstract	Tacrolimus (TAC) is post-transplant pharmacotherapy’s most widely used immunosuppressant. In routine clinical practice, frequent uncomfortable venipuncture is necessary for whole-blood (WB) collection to check trough TAC levels. Volumetric absorptive microsampling (VAMS) is an alternative strategy to WB collection. In this study, we aimed to validate and develop a liquid chromatography–tandem mass spectrometry (LC-MS/MS) method for TAC quantification in WB and VAMS samples. After extraction with water and protein precipitation, the samples were directly analyzed using LC-MS/MS. Whole-blood and VAMS capillary-blood samples were collected from 50 patients treated with TAC during the follow-up visits. The cross-correlation between the developed methods was evaluated using Passing–Bablok regression and a Bland–Altman bias plot. The matrix effect (ME) and carry-over were insignificant for both scenarios. There was a high correlation between the processes and no significant clinical deviation. LC-MS/MS methods were successfully developed and validated in the 0.5–60 ng/mL calibration range. This study demonstrated and confirmed the utility of VAMS-based TAC monitoring in the pediatric population. This is the first study to directly develop and validate the VAMS LC-MS/MS method for evaluating the hematocrit effect in the pediatric population. The statistical correlation between immunochemical and VAMS-based methods was satisfactory.
Journal	Pharmaceutics
Volume Number	15
PubMed Central reference number	PMC9864564
Issue Number	1
PubMed reference number	36678927
e-ISSN	19994923
DOI	10.3390/pharmaceutics15010299
Language	English
Publisher	MDPI
Publisher Date	2023-01-16
Access Restriction	Open
Rights License	Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). © 2023 by the authors.
Subject Keyword	VAMS tacrolimus hematocrit effect whole blood kidney transplantation pediatric population LC-MS/MS microsampling
Content Type	Text
Resource Type	Article
Subject	Pharmaceutical Science