Cyclosporine A, Trough, Blood (CYCLMM)

Test Code

LAB874

Quest Code

15220

Alias/See Also

CYCLMM

CPT Codes
80158

Preferred Specimen

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

Patient Preparation
Optimum time to collect sample is 1 hour before next dose

Minimum Volume

2 mL

Other Acceptable Specimens

Whole blood collected in: Sodium heparin (green-top) tube

Instructions

Do not use gel barrier tubes. Optimum time to collect sample: 1 hour before next dose.

Transport Container

EDTA (lavender-top) tube

Transport Temperature

Room temperature

Specimen Stability

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

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

Received frozen, in gel barrier tube, or clotted

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

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

Setup Schedule

Monday-sunday

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.

Performing Laboratory

Quest Diagnostics Nichols Institute-Chantilly VA

14225 Newbrook Drive

Chantilly, VA 20151-2228

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.