Tubes containing gel (SST and PST) are NOT acceptable
Mycophenolic acid (MPA, mycohenolate) is an immunosuppressive agent that inhibits inosine monophosphate dehydrogenase, an enzyme that controls the rate of synthesis of guanine monophosphate in the de novo pathway of purine synthesis used in the proliferation of B and T cells.
The benefits of therapeutic drug monitoring for MPA are controversial.
The relationship between adverse events and MPA exposure is weak.
The total MPA concentration must be evaluated in the context of a patients renal function and levels of albumin and bilirubin. Renal insufficiency may lead paradoxically to low total MPA levels: MPA clearance is increased as a result of displacement from plasma protein binding sites by increased levels of a metabolite MPAG, and levels of free MPA may be relatively unchanged. Similar perturbations can be observed in hypoalbuminaemia and hyperbilirubinaemia states. Free MPA levels may be informative but there is paucity of data on validated free MPA target values.
After a change in MPA drug dosing, testing should be done when steady state is achieved after 4 days.
Reference intervals are provided Canterbury Health Laboratories and are based on trough samples. Target values for total MPA may vary based on the type of organ transplant; use of concomitant immunosuppressive drugs; trough or timed samples.
Transplant specialists should be consulted for organ specific target values.
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Instructions for Referral |
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| Aliquot Instructions | 3 mL plasma or Serum (1 mL plasma or serum minimum) Fridge 4 o C |
| Aliquot Transport | On ice or ambient |