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.
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