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Lab Dept:
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Chemistry
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Test Name:
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CYCLOSPORINE LEVEL
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General Information
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Lab Order Codes:
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CYCS
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Synonyms:
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CSA, Cyclosporin A, SandimmuneŽ; Gengraf; Neoral
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CPT Codes:
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80158 - Cyclosporine
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Test Includes:
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Cyclosporine level measured in ug/L.
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Logistics
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Test Indications:
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This test is used to monitor blood concentration of cyclosporine A. This test selectively measures only the parent drug. Dose or dose intervals are adjusted to achieve therapeutic concentration.
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Lab Testing Sections:
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Chemistry - Sendouts
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Referred to:
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Fairview University Labs (Fairview test code: CYC)
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Phone Numbers:
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MIN Lab: 612-813-6280
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STP Lab: 651-220-6550
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Test Availability:
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Daily, 24 hours
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Turnaround Time:
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Same day, test set-up daily.
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Special Instructions:
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Usual sampling time is immediately prior to the next dose.
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Specimen
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Specimen Type:
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Whole blood
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Container:
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Lavender top (EDTA) tube
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Draw Volume:
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2 mL (Minimum: 0.4 mL) blood
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Processed Volume:
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Same as Draw Volume
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Collection:
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EDTA whole blood (purple top) is preferred.
Alternate: Heparinized whole blood is acceptable.
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Special Processing:
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Lab Staff: Do Not centrifuge specimen. Submit specimen in original collection container. Store at refrigerated temperature and ship specimen at ambient temperature. Forward promptly.
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Patient Preparation:
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None
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Sample Rejection:
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Mislabeled or unlabeled specimen
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Interpretive
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Reference Range:
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Therapeutic range based on draw immediately prior to next dose.
Therapeutic Default Reference Range: 50 – 400 ug/L
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Kidney Transplant (months post transplant):
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Range (ug/L)
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Pediatric
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0 – 3 months:
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175 - 200
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3 – 6 months:
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150 – 175
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6 – 9 months:
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125 – 150
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9 – 12 months:
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100 – 125
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>12 months:
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75 – 100
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Adult
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0 – 3 months:
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175 – 200
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3 – 6 months:
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150 – 200
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6 – 12 months:
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125 – 150
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>12 months:
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75 – 100
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Heart Transplant (months post transplant)
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Range (ug/mL)
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Pediatric
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0 – 12 months:
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200 –250
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>12 months:
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100 – 125
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EBV PCR >1000 copies/mL:
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80 – 100
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Adult
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0 – 3 months:
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150 – 250
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3 – 6 months:
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125 – 225
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6 – 12 months:
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100 – 200
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>12 months:
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50 – 150
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Heart – Lung Block
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200 – 250
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Lung Transplant (months post transplant)
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Range (ug/L)
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0 – 12 months:
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175 – 225
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>12 months:
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125 – 175
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Liver Transplant (months post transplant)
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Range (ug/L)
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0 – 6 months:
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150 – 200
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>6 months:
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100 – 150
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Pancreas Transplant (months post transplant)
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Range (ug/L)
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0 – 6 months:
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200 – 250
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6 – 12 months:
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150 – 200
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>12 months:
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100 – 150
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Bone Marrow Transplant
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200 – 400 ug/L
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Critical Values:
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>400 ug/L
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Limitations:
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The recommended therapeutic ranges described above apply to trough specimens collected just before the next dose. Blood collected at other times will yield higher results.
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Methodology:
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High Performance Liquid Chromatography/Tandem Mass Spectrometry (HPLC-MS/MS)
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References:
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Fairview-University Medical Center November 2012
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Updates:
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3/4/2004: Test moved from MedTox to Mayo Medical Laboratories. Note: Toxic range changed from >500 to ≥400 ng/mL.
4/20/2004: Reference range change from 100-300 ng/mL to 100-400 ng/mL. Critical range of >400 ng/mL removed. Method changed to HPLC-MS/MS.
1/30/2006: Test moved from Mayo Medical Laboratories to Fairview University Laboratories for faster turnaround time. Note addition of a critical value.
8/20/2009: Critical value previously listed as >600 ug/L.
11/12/2012: Reference range update.
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