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.
Hirvisalo
E L
EL
Department of Clinical Pharmacology, University of Helsinki, Finland.
Kivistö
K T
KT
Neuvonen
P J
PJ
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