Jane Dickerson (Presenter)
Seattle Children's Hospital
Bio: I am a clinical assistant professor in the Department of Laboratory Medicine at the University of Washington, and I am the Co-director of the Chemistry Lab at Seattle Children's Hospital. I am interested in mass spectrometry methods on alternate specimen types to improve patient care for the pediatric population.
Authorship: C. Gordon (1), K. Sadilkova (1), R.M. Jack (1,2), J.A. Dickerson (1,2)
(1) Department of Laboratories Seattle Children's Hospital and (2) Department of Lab Medicine University of Washington
| Short Abstract We have previously described implementing a clinical dried blood spot program for monitoring immunosuppressants. Improving compliance in the adolescent population is a major effort of the clinical team. To assist their efforts, we developed and validated a liquid chromatography-mass spectrometry (LC-MS/MS) assay for quantitation of creatinine in dried blood spots (DBS). The method correlated well with plasma creatinine measured on an Ortho Vitros. We believe this research will improve the clinical utility of remote collection of dried blood spots for renal transplant patients by monitoring both immunosuppressant and creatinine levels. |
Long Abstract
Transplant patients are routinely and chronically monitored with laboratory testing to assess risk of rejection, infection, and to optimize therapeutic drug doses. For renal transplant patients, creatinine is one of the biomarkers which is followed closely. We have previously described implementing a clinical dried blood spot program for monitoring immunosuppressants (1,2). Improving compliance in the adolescent population is a major effort of the clinical team. To assist their efforts, we developed and validated a liquid chromatography-mass spectrometry (LC-MS/MS) assay for quantitation of creatinine in dried blood spots (DBS). We enrolled patients in an IRB-approved study to assess the clinical correlation of venous plasma creatinine measured by Vitros with dried blood spots. The purpose of this research is to assess the clinical utility of remote collection of dried blood spots for both immunosuppressant and creatinine monitoring.
This method uses creatinine-d3 as the calibrators, and creatinine-13C3-d3 as internal standard measured with a SCIEX QTRAP 6500 (3). Limits of detection and quantitation were determined on the equivalent of 3 µL dried blood spot extractions. The method correlated well with plasma creatinine measured on an Ortho Vitros. The impact of hematocrit was evaluated with a spiking study and correlating with plasma level across a range of true patient hematocrit levels.
References & Acknowledgements:
(1) Clin Chim Acta. 2013 Jun 5;421:152-6. doi: 10.1016/j.cca.2013.02.009
(2) Pediatr Transplant. 2015 Feb;19(1):101-6. doi: 10.1111/petr.12392
(3) Anal Bioanal Chem. 2015 407:1585–1594 doi: 10.1007/s00216-014-8415-2
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