Tacrolimus, Highly Sensitive, LC/MS/MS

The following is a list of what is included in the item above. Click the test(s) below to view what biomarkers are measured along with an explanation of what the biomarker is measuring.

Also known as: FK506, Prograf, Tacrolimus Highly Sensitive LCMSMS

Tacrolimus, Highly

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The Tacrolimus, Highly Sensitive, LC/MS/MS test contains 1 test with 1 biomarker.

Brief Description: The Tacrolimus Highly Sensitive test is a specialized assay designed to measure and monitor the levels of tacrolimus in the blood with high precision. Tacrolimus is an immunosuppressive drug frequently administered to patients after organ transplantation to prevent the body's immune system from rejecting the new organ.

Collection Method: Blood Draw

Specimen Type: Whole Blood

Test Preparation: Collect specimen 1 hour prior to next dose (12 hour trough)

When and Why the Tacrolimus Highly Sensitive Test May Be Ordered

  1. Post-Transplant Monitoring: The most common reason to order this test is to monitor tacrolimus levels in patients who have undergone organ transplantation. Maintaining the right balance of tacrolimus is essential. Too much can lead to toxic side effects, while too little may not provide adequate immunosuppression, increasing the risk of organ rejection.

  2. Suspected Toxicity: If a patient exhibits symptoms of tacrolimus toxicity, such as kidney problems or neurological symptoms, the test can help confirm or rule out an overdose.

  3. Dose Adjustments: As the therapeutic window (the range between efficacy and toxicity) for tacrolimus is narrow, frequent testing might be required when adjusting doses.

What the Tacrolimus Highly Sensitive Test Checks For

This test specifically checks for the concentration of tacrolimus in the bloodstream. Given the drug's narrow therapeutic window, even small deviations from the desired range can lead to complications. The "highly sensitive" aspect of the test ensures that very low levels of the drug can be detected, allowing for more precise dosing and monitoring.

Other Lab Tests Ordered Alongside Tacrolimus Highly Sensitive Test

When a Highly Sensitive Tacrolimus test is ordered, it's often part of a broader evaluation of transplant health, drug monitoring, and organ function. Here are some tests commonly ordered alongside it:

  1. Complete Blood Count (CBC) with Differential:

    • Purpose: To evaluate overall blood health, including red and white blood cells, and platelets.
    • Why Is It Ordered: Immunosuppressive therapy, including tacrolimus, can affect blood cell counts, leading to conditions such as anemia or leukopenia.
  2. Kidney Function Test:

    • Purpose: To assess kidney function.
    • Why Is It Ordered: Tacrolimus can be nephrotoxic, especially at high levels. Monitoring kidney function is essential for patients on tacrolimus, particularly for kidney transplant recipients.
  3. Liver Function Test:

    • Purpose: To assess liver health.
    • Why Is It Ordered: To monitor liver function, as tacrolimus metabolism occurs in the liver and liver dysfunction can affect drug levels.
  4. Electrolyte Panel:

    • Purpose: To measure the levels of key electrolytes in the blood.
    • Why Is It Ordered: To monitor for electrolyte imbalances, which can be a side effect of tacrolimus and other medications used in transplant patients.
  5. Magnesium and Calcium Levels:

    • Purpose: To measure the levels of magnesium and calcium in the blood.
    • Why Is It Ordered: Tacrolimus can affect the metabolism of these minerals, leading to imbalances.
  6. Blood Glucose:

    • Purpose: To measure blood sugar levels.
    • Why Is It Ordered: Tacrolimus can impact glucose metabolism, increasing the risk of diabetes in transplant patients.
  7. Lipid Profile:

    • Purpose: To measure levels of cholesterol and triglycerides.
    • Why Is It Ordered: To assess cardiovascular risk, as some immunosuppressive therapies can alter lipid metabolism.

These tests, when ordered alongside a Highly Sensitive Tacrolimus test, provide a comprehensive evaluation of the patient’s health status while on immunosuppressive therapy. They are crucial for ensuring effective immunosuppression, monitoring for potential side effects or toxicity, and maintaining overall organ and system function. The specific combination of tests will depend on the individual’s medical history, type of transplant, and any concurrent medical conditions.

Conditions or Diseases that Require the Tacrolimus Highly Sensitive Test

The primary condition necessitating the Tacrolimus Highly Sensitive test is post-organ transplantation, including:

  • Kidney Transplant
  • Liver Transplant
  • Heart Transplant
  • Other Organ Transplants

The test ensures that the levels of tacrolimus are within the therapeutic window, optimizing chances of transplant success and minimizing side effects.

Usage of Results by Health Care Providers

The results of the Tacrolimus Highly Sensitive test provide health care providers with crucial information regarding the drug's concentration in the patient's system. If levels are too high, the dosage may be adjusted to prevent toxic side effects. Conversely, if levels are too low, there's a risk of the body rejecting the transplanted organ, and an increase in dosage or frequency may be necessary.

By frequently monitoring tacrolimus levels, especially in the initial stages post-transplant, health care providers can optimize treatment regimens, ensuring both the longevity of the transplanted organ and the overall well-being of the patient.

Most Common Questions About the Tacrolimus, Highly Sensitive, LC/MS/MS test:

Purpose and Clinical Indications

What is the primary objective of the Tacrolimus Highly Sensitive test?

The Tacrolimus Highly Sensitive test is primarily designed to measure the concentration of tacrolimus in the blood. Tacrolimus is a potent immunosuppressive drug used primarily to prevent rejection following organ transplantation, such as kidney, liver, or heart transplants. Monitoring tacrolimus levels is crucial to ensure that the patient is receiving an appropriate dose: too much can lead to side effects, and too little can result in organ rejection.

Why might a clinician order the Tacrolimus Highly Sensitive test for a patient?

A clinician may order the Tacrolimus Highly Sensitive test to monitor and adjust the tacrolimus dosage in transplant recipients. Regular monitoring is essential to maintain therapeutic levels, prevent potential toxicity, and reduce the risk of organ rejection. Changes in a patient's condition, interactions with other medications, or alterations in the medication regimen can affect tacrolimus levels, necessitating frequent checks.

Interpretation of Results

What does a high result from the Tacrolimus Highly Sensitive test indicate?

A high result from the Tacrolimus Highly Sensitive test may indicate that the patient's blood concentration of tacrolimus is above the therapeutic range. This can lead to potential toxicity, which includes kidney damage, high blood pressure, and neurotoxic effects. It's essential to adjust the dosage or review any potential drug interactions to bring the level within the recommended therapeutic range.

If the Tacrolimus Highly Sensitive test returns a low result, what might this mean?

A low result from the Tacrolimus Highly Sensitive test suggests that the tacrolimus concentration in the patient's blood is below the therapeutic range. This situation can put the patient at risk for organ rejection due to insufficient immunosuppression. It might require a dosage adjustment or a review of the patient's medication compliance and other factors that could influence drug absorption and metabolism.

Post-Test Management

If the Tacrolimus Highly Sensitive test results are outside the therapeutic range, what are the likely next steps?

If the results from the Tacrolimus Highly Sensitive test are outside the therapeutic range, the clinician will likely review the patient's current dosage and make adjustments as necessary. They may also consider factors like drug interactions, patient adherence to the medication, and issues related to drug absorption or metabolism. In some cases, additional tests may be ordered to assess the patient's overall health and the function of transplanted organs, especially if there are concerns about potential tacrolimus toxicity or organ rejection.

How often should transplant patients undergo the Tacrolimus Highly Sensitive test?

The frequency of the Tacrolimus Highly Sensitive test varies based on several factors, including the type of transplant, time since the transplantation, the patient's overall health, and the presence of any symptoms or complications. Generally, patients are monitored more frequently in the immediate post-transplant period, and the testing frequency may decrease over time if the patient remains stable. However, regular monitoring remains essential throughout the patient's life to ensure therapeutic drug levels.

Clinical Insights

Besides organ rejection, what other conditions or symptoms might be influenced by the results of the Tacrolimus Highly Sensitive test?

Tacrolimus, while primarily used to prevent organ rejection, can have several side effects and implications for a patient's overall health. High levels of tacrolimus, as detected by the Tacrolimus Highly Sensitive test, can be associated with nephrotoxicity (kidney damage), neurotoxicity (including tremors, seizures, or other neurological symptoms), gastrointestinal disturbances, and hypertension. A patient's symptoms, combined with test results, can guide clinicians in their therapeutic decisions and management strategies.

Are there other drugs or treatments that can impact the results of the Tacrolimus Highly Sensitive test?

Yes, several drugs can interact with tacrolimus and influence its blood levels. Some medications can increase tacrolimus concentrations, while others can decrease it. For example, drugs like ketoconazole, voriconazole, and erythromycin can increase tacrolimus levels, while anticonvulsants like phenytoin and carbamazepine can decrease them. It's crucial for clinicians to be aware of all medications and supplements a patient is taking to interpret the Tacrolimus Highly Sensitive test results accurately and make appropriate clinical decisions.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

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