Cyclosporine A Trough, LC/MS/MS, Blood

Test Code
15220

CPT Codes
80158

Preferred Specimen
5 mL whole blood collected in an EDTA (lavender-top) tube

Minimum Volume
2 mL

Other Acceptable Specimens
Sodium heparin (green-top) tube

Instructions
Optimum time to collect sample is 1 hour before next dose.
Do not use gel barrier/serum separator tubes (SST®) for collection.

Transport Temperature
Room temperature

Specimen Stability
Room temperature: 7 days
Refrigerated: 6 days
Frozen: Unacceptable

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Clotted specimen

Methodology
Liquid Chromatography/Tandem Mass Spectrometry (LC/MS/MS)

This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by the FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.

Setup Schedule
Set up: Mon-Sat a.m.; Report available: Same day

Reference Range
No definitive therapeutic or toxic ranges have been established. Opitmal blood drug levels are influenced by type of transplant, patient response, time post-transplant, co-administration of other drugs, and drug formulation.

The following trough ranges are suggested guidelines:
Kidney Transplantation 100-200 mcg/L
Other Organ Transplant 200-300 mcg/L


Clinical Significance
Cyclosporine is a commonly used immunosuppressive drug in patients receiving transplants. LC/MS/MS methods have higher specificity for the parent compound than immunoassay. Therapeutic drug monitoring is useful to optimize dose and avoid toxicity. High cyclosporine levels can lead to nephrotoxicity; Low levels can lead to organ rejection following transplant. Peak concentrations are reached at around 3.5 hours after oral dosage. Elimination half-life is 10-27 hours.



The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.