Al-Uzri A, Freeman K A, Wade Jordan, Clark K, Bleyle L A, Munar M, Koop D R
Department of Pediatrics, Doernbecher Children's Hospital, Oregon Health & Science University (OHSU), Portland, OR, USA.
Department of Pediatrics, Institute on Development & Disability, Oregon Health & Science University, Portland, OR, USA.
Pediatr Transplant. 2017 Sep;21(6). doi: 10.1111/petr.12983. Epub 2017 Jun 20.
The use of DBSs for home monitoring has been limited due to unsatisfactory blood sampling and analytical difficulties. The aim of this longitudinal feasibility trial was to assess the utility of DBS to monitor TAC and Cr at home in transplant recipients. A total of 30 participants (2-21 years, mean±SD, 13.6±5.4 year) were enrolled over 12 months. Eighteen were males. Monthly DBS samples were obtained at home and mailed to the central laboratory for analysis of TAC and Cr. Nineteen patients completed the study, and 216 cards were received in the laboratory from a total of 279 cards expected, with 416/519 (80%) blood spots being suitable for analysis. We found a high correlation between blood TAC and Cr levels by DBS and the clinical laboratory, R =.81 and .95, respectively. Fifteen parents and 15 youth completed measures of satisfaction with and preference for DBS testing. All but one parent/caregiver and youth reported satisfaction and preference for this method of testing over laboratory blood draws. We conclude that home DBS monitoring is a feasible method to monitor TAC and Cr in pediatric transplant recipients.
由于血液采样不尽人意以及分析困难，干血斑（DBS）用于家庭监测的应用一直受到限制。这项纵向可行性试验的目的是评估DBS在家庭中监测移植受者他克莫司（TAC）和肌酐（Cr）水平的效用。在12个月期间共招募了30名参与者（年龄2至21岁，平均±标准差，13.6±5.4岁）。其中18名是男性。每月在家采集DBS样本并邮寄至中心实验室，用于分析TAC和Cr。19名患者完成了研究，实验室共收到279张卡片中的216张，其中416/519（80%）个血斑适合分析。我们发现通过DBS检测的血液TAC和Cr水平与临床实验室检测结果高度相关，相关系数R分别为0.81和0.95。15名家长和15名青少年完成了对DBS检测的满意度和偏好度测量。除一名家长/照顾者和青少年外，所有人都表示对这种检测方法满意，并比对实验室抽血更偏好这种方法。我们得出结论，家庭DBS监测是监测儿科移植受者TAC和Cr水平的一种可行方法。
