Cyclosporine A, 2-Hour Post Dose (C2) by Tandem Mass Spectrometry
Ordering Recommendation
Use to optimize dosing and monitor patient adherence.
New York DOH Approval Status
Specimen Required
Two hour post-dose level should be drawn.
Lavender (EDTA) or pink (K2EDTA).
Transport 1 mL whole blood. (Min: 0.25 mL)
Refrigerated.
Serum or plasma. Specimens left at room temperature for longer than 24 hours. Clotted specimens.
Ambient: 24 hours; Refrigerated: 2 weeks; Frozen: 2 months
Methodology
Quantitative Liquid Chromatography-Tandem Mass Spectrometry
Performed
Sun-Sat
Reported
1-2 days
Reference Interval
Interpretive Data
Cyclosporine A levels in specimens drawn 2 hours post dose may estimate the AUC better than trough specimens. The optimal therapeutic range for a given patient may differ from this suggested range based on the indication for therapy, treatment phase (initiation or maintenance), use in combination with other drugs, time of specimen collection relative to prior dose, type of transplanted organ, and/or the therapeutic approach of the transplant center. A suggested target range for renal transplant is 800-1700 ng/mL. A suggested target range for liver transplant is 600-1000 ng/mL. The higher ranges represent concentrations immediately post transplant and the lower ranges represent concentrations during the maintenance phase.
Laboratory Developed Test (LDT)
Note
Cyclosporine (Sandimmune) whole blood concentrations can be measured by either chromatographic or immunoassay methodologies. These two methodologies are not directly interchangeable, the measured cyclosporine whole blood concentration depends on the methodology used. Reference ranges may vary according to the specific immunoassay or HPLC-MS/MS test. Generally, immunoassays have been reported to have a positive bias relative to HPLC-MS/MS assays due to the detection of antibody cross-reactivity with cyclosporine metabolites.
Hotline History
Hotline History
CPT Codes
80158
Components
Component Test Code* | Component Chart Name | LOINC |
---|---|---|
0058902 | CyclosporineA, 2-Hr Post(C2), HPLC-MS/MS | 32997-9 |
Aliases
- Gengraf
- Neoral
- Restasis
- Sandimmune