Grafted patients necessitate lifelong treatment with immunosuppressants in order to prevent graft rejection or toxicity. Because those drugs show extensive inter and intra-patient pharmacokinetic variability, frequent drug monitoring and individualized dose adjustments are required to ensure the patient’s exposure to the therapeutic drugs remains within their respective optimal therapeutic window.

Therapeutic drug monitoring (TDM) based on full area under the concentration-time curve (AUC) is considered the most accurate estimation of patient’s drug exposure. However, this approach is a real burden for patients, because it implies travelling back and forth to the clinic/hospital for repeated time-consuming and invasive sampling sessions. Lighter approaches such as trough concentration measurement and abbreviated AUC are generally preferred, but patients still require spending several hours at the clinic on a regular basis, which can dramatically worsen patients’ quality of life.

In order to alleviate grafted patients monitoring constraints, the group of Dr Dirk Jan Moes from the department of Clinical Pharmacy and Toxicology of Leiden University Medical Center has evaluated the use of HemaXis™ DB10 in replacement of conventional venipuncture for tacrolimus and mycophenolic acid dose adjustment and follow-up. The main objective is to make patients’ life easier by proposing a simpler and less invasive sampling approach, which would enable them to collect samples themselves at home and reduce the need for visits at the clinic.