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Laboratory:

Clinical Biochemistry (SPECIAL CHEMISTRY)

Test Name:

MYCOPHENOLIC ACID (MPA) - (P)

Test Code: MYPA

Clinical Information:

Description: Mycophenolic acid (MPA) is an active metabolite of mycophenolate mofetil (MMF), an immunosuppressant medication used to prevent transplant rejection. It is typically used in combination with calcinurine inhibitors and steroids. MPA is a selective, noncompetitive, and reversible inhibitor of inosine monophosphate dehydrogenase (IMPDH), an enzyme in de novo synthesis of guanosine.
Test Indications: Monitoring of MPA levels can be useful immediately after therapy is initiated (up to 3 weeks) or upon major changes in health status.
It is important to note that effective therapeutic range depends on numerous factors, including type of transplant, time post-transplant, patient's clinical status (e.g. organ function), and co-medication.

Collection Devices:

Preferred Device:	1 - Li Heparin, NO GEL 4.0 mL Tube(s) - Full Tube Collection Li Heparin, NO GEL 4.0 mL Tube(s) - Full Tube Collection Manufacturer: BD (Becton Dickinson) Catalogue #: 367884
Alternate Device:	1 - Microtainer(s) - Li Heparin NO GEL (0.4 mL) to fill line Microtainer(s) - Li Heparin NO GEL (0.4 mL) to fill line Manufacturer: Becton Dickinson & Company Catalogue #: 365965

Gel tubes are not acceptable. Serum (red top, no gel) is acceptable.

Specimen Required:

Plasma: 1.0 mL

Pediatric Plasma: 0.3 mL

Collection Information: Optimum time to collect 30-60 min before next dose (trough) at steady-state (3-5 days on the same dose).
Special Processing: Include on requisition form date and time of last dose prior to sample collection
Specimen Stability:
Ambient: 8 hours
Refrigerated: 14 days
Frozen: 11 months at -20 C

Referral:

Shipping & Storage: Separate plasma and aliquot. Store and send refrigerated or frozen to HSC Clinical Chemistry - MS5. Avoid repeat freeze-thaw cycles.

Requisition:

_SH Biochemistry Hematology Requisition (R250-10-92)

_SH Hospital Biochemistry Hematology Non Winnipeg Brandon (R250-10-91)

_SH Winnipeg Brandon Biochemistry Hematology Requisition (R250-10-94)

_SH Winnipeg Brandon Hospital Biochemistry Hematology Requisition (R250-10-93)

Reference Values:

Reference Intervals:
Therapeutic range (trough): 1.0 - 3.5 mg/L
Toxic range: >25.0 mg/L

*Trough: just before the next regular dose; steady-state: 3-5 days at the same dose

Specimens collected outside of steady-state trough period in the dosing cycle are likely to have higher MPA levels and trough therapeutic range should not be applied.
Method of Analysis: LC-MS/MS (Laboratory Developed Test)

Availability:

Once Per Week

Test is performed at HSC every Friday. For same day analysis, samples must be received at HSC prior to 12 pm on Friday.