Ciclosporin - LC/MS
Liver Pathology Overview / Directory
Purpose of the test
Liquid chromatography-tandem mass spectrometric monitoring of whole blood concentrations of ciclosporin (cylosporin A or cyclosporine). Gold-standard assay for best management of dosage of Neoral, Sandimmun and SangCyA used in immunosuppression.
Test PDF
Reference Range
Varies widely with indication and patient characteristics but usually within the range 20-350 µg/L. Please seek advice from the providers: 020 3299 3147.
Sample Requirements
Pre-dose whole blood sample taken in EDTA (0.5mL minimum; 12h post-dose for bd dosing).
Please submit with a request form showing the last dose, last dose time and sample time/date.
Storage and Transport
Ciclosporin is stable in blood at normal ambient temperatures for several weeks. Ship adequately contained samples by 1st class mail or courier depending on urgency. Send directly to IDM Service, Institute of Liver Studies, King’s College Hospital, Denmark Hill, London SE5 9RS, UK to avoid delays.
Turnaround Time
Same day Monday to Friday for samples received before 3 to 3.30 pm.
Time Limit for Extra Tests
Same day for other immunosuppressants e.g., tacrolimus, sirolimus or mycophenolate in the same sample.
Factors affecting results or interpretation
Interpretation is affected by indication for ciclosporin, time from start of therapy, immunosuppressant comedication and patient’s clinical condition. Results vary during co-medication with inducers and inhibitors of cytochrome P450 3A and P-glycoprotein and with liver function (see Purpose of the Test).
Contacts
IDM service: kch-tr.KCHIDMService@nhs.net
