Analysis of errors in tacrolimus blood level measurements related to different methods of sampling blood through a central venous catheter

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  • Sekiguchi Masahiro
    Department of Pediatrics, The University of Tokyo Hospital
  • Arakawa Yuki
    Department of Hematology/Oncology, Saitama Children’s Medical Center
  • Osumi Tomoo
    Children’s Cancer Center, National Center for Child Health and Development
  • Isobe Kiyotaka
    Department of Hematology/Oncology, Saitama Children’s Medical Center
  • Takita Junko
    Department of Pediatrics, The University of Tokyo Hospital
  • Hanada Ryoji
    Department of Hematology/Oncology, Saitama Children’s Medical Center
  • Tomizawa Daisuke
    Children’s Cancer Center, National Center for Child Health and Development
  • Matsumoto Kimikazu
    Children’s Cancer Center, National Center for Child Health and Development
  • Oka Akira
    Department of Pediatrics, The University of Tokyo Hospital
  • Koh Katsuyoshi
    Department of Hematology/Oncology, Saitama Children’s Medical Center
  • Kato Motohiro
    Department of Pediatrics, The University of Tokyo Hospital Department of Cell Therapy and Transplantation Medicine, The University of Tokyo Hospital

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Other Title
  • 中心静脈カテーテルからの逆流採血方法の差異とタクロリムス血中濃度測定の誤差に関する検討

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 Tacrolimus is usually administered continuously through one lumen of a double-lumen central venous catheter (CVC) in allogeneic hematopoietic stem cell transplantation. Although blood samples for therapeutic drug monitoring are taken through the other CVC lumen in children, the drug-concentration result is often falsely elevated. In order to reduce measurement errors obtained when collecting blood samples through a CVC, we retrospectively compared two blood-sampling methods: the standard method and a “flushing method,” in which the lumen is flushed with 5 mL saline before drawing blood. The flushing method significantly reduced measurement errors (median Rc [the ratio of the drug concentration measured in the blood sample collected through the CVC to that collected using venipuncture], 1.019 vs 1.142; p=1.8×10−10). In conclusion, the flushing method was an effective and more accurate means of monitoring blood concentration without the need for frequent venipuncture.

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