01 January 2009
Review of the newest HPLC methods with mass spectrometry detection for determination of immunosuppressive drugs in clinical practice
Magdalena Korecka, Leslie M ShawAnn Transplant 2009; 14(2): 61-72 :: ID: 880524
Abstract
High performance liquid chromatography coupled with electrospray mass spectrometry is widely used for quantitative determination of immunosuppressive drugs (sirolimus, tacrolimus, everolimus, CsA and MPA) in biological fluids. The growth in volume for testing these drugs and economic constraints in clinical laboratories has led to heightened demand for high throughput methods. Fast-flow on-line extraction with switching valve technique and implementation of automation accelerates sample preparation. For on-line purification the combination of fast flow of washing solution and narrow-bore extraction column provides a clean sample in a very short time without compromising precision and accuracy. The unique feature of multireactant monitoring tandem mass spectrometry reduces significantly the need for chromatographic separation, as long as matrix effects are not detected, and permits simultaneous measurement of several drugs in one run when they are present in the same specimen. Additionally, the same method together with the identical sample preparation and HPLC-MS conditions and setting can be used for measurement of all five immunosuppressants, four of them in blood, MPA in plasma. Thanks to the high sensitivity of LC-MS only a small volume of biological sample is required for analysis. However for MPA quantitation, mass interference attributable to in-source fragmentation of its glucuronide metabolite can be a problem if the latter is not chromatographically separated from the parent drug before introduction of the sample into the ion source. Thus, chromatographic separation is extremely important for MPA analysis. In conclusion, important features of LC-MS methodology for immunosuppressive drugs include: shortened analysis time, increased throughput, selectivity and lower cost of analysis.
Keywords: immunosuppressive drugs, therapeutic drug monitoring, Vein graft diseasae
In Press
Original article
Steroid Use in ABO-Incompatible Kidney Transplants: Withdrawal vs MaintenanceAnn Transplant In Press; DOI: 10.12659/AOT.947747
Original article
Intra-Arterial Contrast-Enhanced Ultrasound for Transcatheter Thrombolysis in Post-Transplant Hepatic Arter...Ann Transplant In Press; DOI: 10.12659/AOT.947500
Original article
Early Atropine Protocol Enhances Dobutamine Stress Echocardiography in End-Stage Liver Disease: A Practical...Ann Transplant In Press; DOI: 10.12659/AOT.950166
Most Viewed Current Articles
15 Aug 2023 : Review article 7,349
Free-Circulating Nucleic Acids as Biomarkers in Patients After Solid Organ TransplantationDOI :10.12659/AOT.939750
Ann Transplant 2023; 28:e939750
03 Jan 2023 : Original article 7,205
Impact of Autologous Stem Cell Transplantation on Primary Central Nervous System Lymphoma in First-Line and...DOI :10.12659/AOT.938467
Ann Transplant 2023; 28:e938467
16 May 2023 : Original article 7,029
Breaking Antimicrobial Resistance: High-Dose Amoxicillin with Clavulanic Acid for Urinary Tract Infections ...DOI :10.12659/AOT.939258
Ann Transplant 2023; 28:e939258
28 May 2024 : Original article 6,629
Effect of Dexmedetomidine Combined with Remifentanil on Emergence Agitation During Awakening from Sevoflura...DOI :10.12659/AOT.943281
Ann Transplant 2024; 29:e943281