ESPN 53rd Annual Meeting

ESPN 2021


 
Home testing to measure creatinine and tacrolimus levels: A collaboration during the COVID19 pandemic
HELEN JONES 1 RACHEL CARLING 2 DONNA AUSTIN 2 ERIN EMMETT 2 LOUISE KIPPING 1 GRAINNE WALSH 1 NICK WARE 1 DAVID MARSHALL 3 JON JIN KIM 4

1- EVELINA LONDON CHILDRENS HOSPITAL
2- ST THOMAS HOSPITAL
3- MANCHESTER UNIVERSITY FOUNDATION TRUST
4- QUEENS MEDICAL CENTRE
 
Introduction:

 During the first wave of the COVID19 pandemic all paediatric renal transplant recipients (pRTR) in the UK were required to shield driving a reduction in their face to face outpatient clinics and an increase in virtual reviews in our centre. Re-configuration of the transplant service was required to enable effective monitoring of pRTRs. We describe a testing method set up responsible for reducing some hospital or primary care visits.

Material and methods:

 Collaboration between 2 UK paediatric nephrology centres and 2 laboratories enabled setting up of a home testing method (finger prick sample) to measure creatinine and tacrolimus level using Mitra tips which could be undertaken by pRTRs and their parent/carer. The samples are then posted to the tertiary centre.

Results:

Mitra tip finger prick method measures creatinine(umol/L) and tacrolimus(ug/l). Extensive testing was carried out by our biochemistry colleagues to set up the assays, ensuring results comparable to standard laboratory testing used in our centre.

To date this home-testing has been used for 1. Monitoring between outpatient visits to reduce frequency of visits in stable pRTRs 2. Enabling monitoring of tacrolimus levels after dose adjustment 3. Facilitating early creatinine re-check if graft function elevated from baseline at routine clinic visit 4. Checking an accurate 12h trough tacrolimus level in pRTR who is unable to do this in clinic.

 

Conclusions:

 Home testing to measure creatinine and tacrolimus levels in pRTRs using Mitra tips allows increased flexibility with respect to the monitoring of transplant function we are able to offer. Though it was established in our centre through collaboration during the pandemic, it will be used going forwards to facilitate some of the patients’ monitoring enabling a reduction in missed school days for patients and less time off work for their families. We hope it can be used in other patient groups receiving tacrolimus therapy.