Pathology Handbook

Mycophenolic Acid (Sendaway Test)

Register all four specimens under the first episode request number. Please ensure that when aliquoting EDTA samples that each aliquot is labelled with time and date of collection. Blood collection for this test is only performed at NPV collection rooms at Northern Hospital.

Collection involves four samples of 4 mL into EDTA tubes - for Oral dosing collect pre-dose and +1 hr, +2 hr, +4 hr post dose, for IV infusion collect pre-dose +2 hr, +4 hr, +6 hr post start of infusion.  Transport to the laboratory on ice. 

Record on the tube labels and on the MPA AUC Sample Collection Form, the exact time of the dose and of the specimen collections along with other required details.

Pre-Dose - Pre-Dose sampling is useful for checking patient compliance or suspected toxicity. A universal reference range is not applicable.  Correlation between Pre-dose plasma levels of total MPA and clinical outcome depend on the specific clinical setting/patient population and have not been firmly established in some settings.

Mycophenolic acid (MPA) total, estimation of AUC 0-12 hr - plasma.

Estimation of AUC 0-12 hr uses a limited sampling approach.  It requires 4 samples (Pre-dose, +1hr, +2 hr, +4hr post dose).

To ensure capture of all data a completed copy of the specific form (downloadable from www.austinpathology.org.au/forms) is required to be sent with the samples for the MPAAUC tests.

Oral form:

https://s3-ap-southeast-2.amazonaws.com/syd.static.austinpathology.org.au/test/pdf/Yeq8lI7guUobO2J/1565669702/Mycophenolic%20Acid,%20Estimated%20AUC%20-%20Oral_303%20FOR-IT-002.pdf

IV form:

https://s3-ap-southeast-2.amazonaws.com/syd.static.austinpathology.org.au/test/pdf/EBAZUQdkGgDNaai/1565669734/Mycophenolic%20Acid,%20Estimated%20AUC%20-%20IV%20Infusion_303%20%20FOR-IT-003.pdf

Oral 6-point/paediatric from:

https://s3-ap-southeast-2.amazonaws.com/syd.static.austinpathology.org.au/test/pdf/GyzVydXk72YYsui/1565671649/Mycophenolic%20Acid,%20Estimated%20AUC%20-%20Oral%206-point_301%20FOR-IT-004.pdf

A reference range is currently being established. In renal and cardiac transplant recipients an AUC 0-12 hr of 30 to 60 mg.hr/L in the initial phase after transplantation has been shown to associate with less rejection (see Elbarbry FA and Shoker AS, 2007, Clin. Biochem 40:752 for review).

For further information please contact Andrew Ellis, Clinical    Pharmacology and Therapeutics Unit, Austin Pathology on 94963220.