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Test Code Billings Clinic: 8620 Mayo: CYSPR Cyclosporine, Blood

Reporting Name

Cyclosporine, B

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Useful For

Monitoring whole blood cyclosporine concentration during therapy, particularly in individuals coadministered cytochrome P450 (CYP) 3A4 substrates, inhibitors, or inducers

 

Adjusting dose to optimize immunosuppression while minimizing toxicity

 

Evaluating patient compliance

Method Name

Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)


Specimen Required


Container/Tube: Lavender top (EDTA)

Specimen Volume: 3 mL

Collection Instructions:

1. Collect specimen immediately before a scheduled dose.

2. Do not centrifuge.

3. Send whole blood specimen in original tube. Do not aliquot.

Additional Information: Therapeutic range applies to trough specimens collected immediately prior to a.m. dose.


Specimen Type

Whole Blood EDTA

Specimen Minimum Volume

1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Whole Blood EDTA Refrigerated (preferred) 14 days
  Ambient  14 days
  Frozen  14 days

Reject Due To

Gross hemolysis OK
Gross lipemia OK
Gross icterus OK
Clotted specimens Reject

Reference Values

100-400 ng/mL (trough)

 

Target steady-state trough concentrations vary depending on the type of transplant, concomitant immunosuppression, clinical/institutional protocols, and time posttransplant. Results should be interpreted in conjunction with this clinical information and any physical signs/symptoms of rejection/toxicity.

Interpretation

Most individuals display optimal response to cyclosporine with trough whole blood levels 100 to 400 ng/mL. Preferred therapeutic ranges may vary by transplant type, protocol, and comedications.

 

Therapeutic ranges are based on specimens collected at trough (ie, immediately before the next scheduled dose). Higher results will be obtained when the blood is drawn at other times.

 

This test may also be used to analyze cyclosporine levels 2 hours after dosing (C2 concentrations); trough therapeutic ranges do not apply to C2 specimens.

 

The assay is specific for cyclosporine; it does not cross-react with cyclosporine metabolites, sirolimus, sirolimus metabolites, tacrolimus, or tacrolimus metabolites. Results by liquid chromatography with detection by tandem mass spectrometry are approximately 30% less than by immunoassay.

Day(s) Performed

Monday through Sunday

Report Available

Same day/1 day

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

80158

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CYSPR Cyclosporine, B 3520-4

 

Result ID Test Result Name Result LOINC Value
35143 Cyclosporine, B 3520-4

Forms

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-Renal Diagnostics Test Request (T830)

-Therapeutics Test Request (T831)