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Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS
Published on: November 8, 2015
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Does CytoSorb Interfere with Immunosuppression? A Pharmacokinetic and Functional Evaluation.
Stephan Harm1, Claudia Schildböck1, Denisa Cont1
1Department for Biomedical Research, University for Continuing Education Krems, 3500 Krems, Austria.
Pharmaceutics
|November 27, 2025
Summary
The CytoSorb hemoadsorption device significantly reduces levels of several immunosuppressants like methylprednisolone and mycophenolic acid during organ transplantation. Short-term use showed minimal impact on immune function, suggesting cautious application in transplant patients.
Area of Science:
- Immunology
- Transplantation Medicine
- Critical Care
Background:
- Cytokine release post-organ transplantation can cause primary graft dysfunction.
- Immunomodulation is crucial for managing post-transplant complications.
- The impact of CytoSorb, a cytokine-reducing hemoadsorption device, on immunosuppressive drugs is not well understood.
Purpose of the Study:
- To investigate the adsorption of key immunosuppressants by CytoSorb ex vivo.
- To compare CytoSorb's drug removal capacity with dialysis.
- To assess the functional impact of CytoSorb on leukocyte activation and cytokine release.
Main Methods:
- Ex vivo hemoadsorption circuit using CytoSorb with five immunosuppressants.
- Comparison with chronic and acute dialysis.
- Whole blood model with LPS/anti-CD3 stimulation to measure cytokine release (TNF-α, IL-1β, IL-6, IL-8).
Main Results:
- CytoSorb significantly reduced methylprednisolone (92%), mycophenolate (80%), 6-mercaptopurine (65%), and cyclosporine A (61%).
- Tacrolimus levels were not significantly affected by CytoSorb.
- Dialysis showed variable removal, with minimal effect on protein-bound drugs like cyclosporine A and tacrolimus.
- CytoSorb treatment did not significantly alter cytokine release post-stimulation in the whole blood model.
Conclusions:
- CytoSorb effectively reduces plasma concentrations of certain immunosuppressive medications.
- Short-term CytoSorb application appears to preserve overall immunosuppressive efficacy.
- Findings support cautious use of CytoSorb in transplant patients, pending in vivo validation.
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