Therapeutic cyclosporine monitoring: comparison of radioimmunoassay and high-performance liquid chromatography methods in organ transplant recipients.
We have determined blood cyclosporine concentrations using three different methods in a total of 212 therapeutic monitoring specimens from heart, liver, kidney, and bone marrow, transplant recipients. The specimens were analyzed by radioimmunoassay using a polyclonal nonspecific antibody (RIA, Ciclosporin RIA-Kit), radioimmunoassay using a monoclonal specific antibody (SRIA, Sandimmun Kit), and by high-performance liquid chromatography (HPLC). When the nonspecific antibody was used, mean RIA/HPLC ratios in different patient groups ranged from 2.3 to 5.5, and the variability in this ratio was large in all groups. When the specific antibody was used, mean SRIA/HPLC ratios in different groups ranged from 1.1 to 1.5, with smaller variability. It can be concluded that radioimmunoassay using a specific monoclonal antibody is well suited for therapeutic monitoring of blood cyclosporine concentrations. However, even this method overestimates cyclosporine concentrations in certain patients.
Department of Clinical Pharmacology, University of Helsinki, Finland.
E L
EL
Hirvisalo
K T
KT
Kivistö
P J
PJ
Neuvonen
D000328:Adult; D016026:Bone Marrow Transplantation / Q000502:physiology; D002851:Chromatography, High Pressure Liquid / Q000379:methods; D003524:Cyclosporins / Q000097:blood / Q000493:pharmacokinetics*; D016027:Heart Transplantation / Q000502:physiology; D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology; D016031:Liver Transplantation / Q000502:physiology; D011863:Radioimmunoassay / Q000379:methods
D003524:Cyclosporins