Mycophenolic Acid, Serum
Use
Mycophenolate mofetil (CellCept) is an immunosuppressive agent beneficial in organ transplantation, approved for use in renal, hepatic, and cardiac transplants. Once in the bloodstream, it converts to the active form, mycophenolic acid (MPA), which selectively inhibits the de novo pathway of guanosine nucleotide synthesis in lymphocytes, curtailing T and B lymphocyte proliferation. Monitoring the blood levels of MPA and its metabolite, MPA glucuronide (MPA-G), is crucial to customize therapy and prevent excessive immunosuppression, which can predispose patients to systemic infections. Adjustments are often required before and after changes in immunosuppressive therapy or when significant changes in health status occur.
Special Instructions
It is imperative to collect a trough serum specimen, right before the next regular dose, as specimens collected at other times in the dosing cycle may not reflect accurate therapeutic levels. Use the Sarstedt Aliquot Tube, 5 mL (T914) for collection, and ensure the specimen is centrifuged and aliquoted into a plastic vial. Specimen collection should occur immediately before the next scheduled dose.
Limitations
Specimens collected outside the trough timeframe can yield higher MPA levels, rendering the standard reference range inapplicable. Proper interpretation hinges on trough serum collection to infer therapeutic levels accurately. Careful specimen handling and timing in the collection process are essential to avoid misinterpretation and subsequent clinical mismanagement. Additionally, the test's performance has not received FDA clearance, adhering only to CLIA stipulations set by Mayo Clinic.
New York Approved
Methodology
Mass Spectrometry (LC-MS/MS)
Biomarkers
LOINC Codes
- 87432-1
- 23905-3
- 23906-1
Result Turnaround Time
1-3 days
Related Documents
For more information, please review the documents below
Specimen
Serum
Volume
1 mL
Minimum Volume
0.25 mL
Container
Plastic vial
Collection Instructions
Draw blood immediately before the next scheduled dose (trough). Centrifuge and aliquot serum into a plastic vial.
Storage Instructions
Refrigerate serum preferred, store up to 28 days.
Causes for Rejection
Specimens from serum gel/SST tubes are not acceptable.
Stability Requirements
| Temperature | Period |
|---|---|
| Room Temperature | 21 days |
| Refrigerated | 28 days |
| Frozen | 28 days |