Evaluation of four automated methods for determination of whole blood cyclosporine concentrations

Am J Clin Pathol. 1999 Sep;112(3):358-65. doi: 10.1093/ajcp/112.3.358.

Abstract

Cyclosporine is a widely used and potent immunosuppressant drug with a narrow therapeutic index. Therefore, cyclosporine concentrations should be monitored closely. Various automated immunologic methods for cyclosporine whole blood determinations are available. Two new methods, fluorescence polarization immunoassay (FPIA) for the AxSYM by Abbott Laboratories, Chicago, IL, and the cloned enzyme donor immunoassay (CEDIA) by Boehringer Mannheim, Mannheim, Germany, have been introduced. In addition, Dade Behring improved its enzyme multiplied immunoassay (EMIT) assay. The present study evaluated all 3 new methods in comparison with high-performance liquid chromatography (HPLC) and the FPIA for the TDx analyzer. We measured whole blood cyclosporine concentrations of 179 samples obtained from 127 patients after kidney, bone marrow, heart-lung, and liver transplantation. All 4 automated immunologic methods can be used for routine measurement of cyclosporine whole blood concentrations. Disadvantages, such as higher cross-reactivity (Abbott TDx, CEDIA) or a limited linearity range (EMIT), are accompanied by advantages, such as a high precision (Abbott TDx) or an easy sample handling procedure (CEDIA). Information presented in this article should help to find the most adequate cyclosporine method for each medical laboratory.

Publication types

  • Comparative Study

MeSH terms

  • Antibodies, Monoclonal
  • Autoanalysis / methods*
  • Bone Marrow Transplantation
  • Chromatography, High Pressure Liquid
  • Cyclosporine / blood*
  • Evaluation Studies as Topic
  • Heart Transplantation
  • Humans
  • Immunoassay
  • Immunosuppressive Agents / blood*
  • Kidney Transplantation
  • Linear Models
  • Liver Transplantation
  • Reproducibility of Results

Substances

  • Antibodies, Monoclonal
  • Immunosuppressive Agents
  • Cyclosporine