Analysis of tacrolimus and creatinine from a single dried blood spot using liquid chromatography tandem mass spectrometry

Dennis R. Koop, Lisa A. Bleyle, Myrna Munar, Ganesh Cherala, Amira Al-Uzri

Research output: Contribution to journalArticlepeer-review

70 Scopus citations


Long term therapeutic drug monitoring and assessment of renal function are required in renal transplant recipients on immunosuppressant therapy such as tacrolimus. Dry blood spots (DBS) have been used successfully in the clinic for many years and offers a convenient, simple and non-invasive method for repeated blood tests. We developed and performed a preliminary validation of a method for the analysis of tacrolimus and creatinine from a single DBS using liquid chromatography-tandem mass spectrometric (LC-MS/MS). Tacrolimus and creatinine were extracted from a 6. mm punch with a mixture of methanol/acetonitrile containing ascomycin and deuterated creatinine as internal standards. A 10. μl aliquot of the extract was analyzed directly after dilution for creatinine with normal phase high performance liquid chromatography and multiple reaction monitoring. The remainder of the extract was processed and analyzed for tacrolimus. The lower limit of quantification for tacrolimus was 1. ng/ml with accuracy of 0.34% bias and precision (CV) of 11.1%. The precision ranged from 1.33% to 7.68% and accuracy from -4.44% to 11.6% bias for the intra- and inter-day analysis. The lower limit of quantification of creatinine was 0.01. mg/dL with precision of 7.94%. Accuracy was based on recovery of additional creatinine spiked into whole blood samples and ranged from -2.45% bias at 5. mg/dL to 3.75% bias at 0.5. mg/dL. Intra- and inter-day precision was from 3.48 to 4.11%. The assay was further validated with DBS prepared from pediatric renal transplant recipients. There was excellent correlation between the levels of tacrolimus and creatinine obtained from the clinical laboratory and the DBS method developed. After additional validation, this assay may have a significant impact on compliance with medication intake as well as potentially lowering the cost associated with intravenous blood draws in clinical laboratories.

Original languageEnglish (US)
Pages (from-to)54-61
Number of pages8
JournalJournal of Chromatography B: Analytical Technologies in the Biomedical and Life Sciences
StatePublished - May 1 2013


  • Creatinine
  • Dried blood spot (DBS)
  • Liquid chromatography tandem mass spectrometry (LC-MS/MS)
  • Tacrolimus
  • Therapeutic drug monitoring

ASJC Scopus subject areas

  • Analytical Chemistry
  • Biochemistry
  • Clinical Biochemistry
  • Cell Biology


Dive into the research topics of 'Analysis of tacrolimus and creatinine from a single dried blood spot using liquid chromatography tandem mass spectrometry'. Together they form a unique fingerprint.

Cite this