Bhxky4pz3e2ooonkc34tg40j

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Name : Ms. SHIVANI BHATT

Lab No. : 389881693 Age : 21 Years
Ref By : Dr. VINAY RATHORE Gender : Female
Collected : 17/3/2023 11:07:00AM Reported : 18/3/2023 6:07:22PM
A/c Status : P Report Status : Final
Collected at : MODERN PATH LAB Processed at : LPL-NATIONAL REFERENCE LAB
C/O Modern Pathology Lab, Shop No 3,4,5,6 and National Reference laboratory, Block E,
8, Ground Floor, Garcha Complex, Jail Road, Sector 18, Rohini, New Delhi -110085
Kutchery Chowk, Raipur, Chhattisgarh - 492001
Test Report
Test Name Results Units Bio. Ref. Interval
TACROLIMUS (FK-506), WHOLE BLOOD 1.68 ug/L

(LC-MS / MS)
Interpretation
-------------------------------------------------------------------
| KIDNEY TRANSPLANT | POST TRANSPLANT | THERAPEUTIC RANGE in ug/L |
|-------------------|-------------------|----------------------------|
| PEDIATRIC | 0-3 months | 10-12 |
| | 3-6 months | 8-10 |
| | 6-12 months | 6-8 |
| | >12 months | 4-7 |
|-------------------|-------------------|----------------------------|
| ADULT | 0-6 months | 8-10 |
| | 6-12 months | 6-8 |
| | >12 months | 4-6 |
| | >5 Years | 3-5 |
|-------------------|-------------------|----------------------------|
| | Toxic range | >20 |
--------------------------------------------------------------------
-------------------------------------------------------------------
| LIVER TRANSPLANT | POST TRANSPLANT | THERAPEUTIC RANGE in ug/L |
|-------------------|-------------------|----------------------------|
| PEDIATRIC | 0-3 months | 10-12 |
| | 3-6 months | 8-10 |
| | >6 months | 6-8 |
|-------------------|-------------------|----------------------------|
| ADULT | 0-3 months | 10-12 |
| | 3-6 months | 8-10 |
| | >6 months | 6-8 |
|-------------------|-------------------|----------------------------|
| | Toxic range | >20 |
--------------------------------------------------------------------
Note: 1. Therapeutic range is based on whole blood specimen drawn 12 hrs post dose or prior
to next dose (trough)
2. Factors affecting Tacrolimus concentration in blood are:

o Nature of transplant
o Age and general health of the patient
o Co-administration of drugs
o Intake of drug with meal
o Time post transplant
3. Tacrolimus Whole blood concentrations can be measured by either chromatographic (LC-MS/MS) or

immunoassay (CLIA) methodologies. These two techniques are not directly interchangeable and the
measured drug level depends on the methodology used. Reference ranges are different for the two
PatientReportSCSuperPanel.SP_GENERAL_TEMPLATE01_SC (Version: 7)
*389881693*
Page 1 of 3
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Lab No. : 389881693 Age : 21 Years
Test Report

methodologies. Generally CLIA has a positive bias as compared with LC-MS/MS due to cross reacting
antibodies with the drug metabolites.
Comments
LC-MS/MS is considered the most sensitive, specific and precise technology for monitoring
immunosuppressants . Therapeutic drug monitoring ( TDM) is commonly used to help maintain drug levels
within the concentration range in which the drug exerts its clinical effect with minimal adverse reactions.
Tacrolimus is a potent immunosuppressant approved for prophylaxis of organ rejection in patients receiving
allogeneic liver transplants. It has also been used effectively in other solid organ transplant patients like kidney
transplant for prevention of graft versus host disease as well as in pancreatic islet transplantation. It exerts
immunosuppressive effect following the formation of a complex with immunophilins. It’s absorption from
small intestine is highly variable ranging from 4-93% and changes with time following transplant surgery.
Even the elimination half life of Tacrolimus is variable being 12 hours in liver transplant patients and 19 hours
in renal transplant patients.
Indications for testing
· Immunosuppressant dose optimization
· Failure to respond to immuosuppressants
· Signs or Symptoms consistent with inadequate or excessive immunosuppression
· Changes to concomitant medications or other variables that affect pharmacokinetics
Dr Himangshu Mazumdar Dr.Kamal Modi Dr Nimmi Kansal

MD, Biochemistry MD, Biochemistry MD, Biochemistry
Sr. Consultant Biochemist Consultant Biochemist Technical Director - Clinical
NRL - Dr Lal PathLabs Ltd NRL - Dr Lal PathLabs Ltd Chemistry & Biochemical Genetics
NRL - Dr Lal PathLabs Ltd
-------------------------------End of report --------------------------------

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*389881693*
Page 2 of 3
.

Lab No. : 389881693 Age : 21 Years
Test Report
IMPORTANT INSTRUCTIONS
ŸTest results released pertain to the specimen submitted .ŸAll test results are dependent on the quality of the sample received by the Laboratory .
ŸLaboratory investigations are only a tool to facilitate in arriving at a diagnosis and should be clinically correlated by the Referring Physician .ŸReport
delivery may be delayed due to unforeseen circumstances. Inconvenience is regretted .ŸCertain tests may require further testing at additional cost for
derivation of exact value. Kindly submit request within 72 hours post reporting.ŸTest results may show interlaboratory variations .ŸThe Courts/Forum
at Delhi shall have exclusive jurisdiction in all disputes /claims concerning the test(s) & or results of test(s).ŸTest results are not valid for medico legal
purposes.ŸThis is computer generated medical diagnostic report that has been validated by Authorized Medical Practitioner /Doctor.ŸThe report does
not need physical signature.
(#) Sample drawn from outside source.
If Test results are alarming or unexpected, client is advised to contact the Customer Care immediately for possible remedial action.
Tel: +91-11-49885050,Fax: - +91-11-2788-2134, E-mail: lalpathlabs@lalpathlabs.com
National Reference lab, Delhi, a CAP (7171001) Accredited, ISO 9001:2015 (FS60411) & ISO 27001:2013 (616691) Certified laboratory.
*389881693*
Page 3 of 3

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Name : Ms. SHIVANI BHATT

Test Name Results Units Bio. Ref. Interval

TACROLIMUS (FK-506), WHOLE BLOOD 1.68 ug/L

2. Factors affecting Tacrolimus concentration in blood are:

3. Tacrolimus Whole blood concentrations can be measured by either chromatographic (LC-MS/MS) or

Name : Ms. SHIVANI BHATT

Test Name Results Units Bio. Ref. Interval

Dr Himangshu Mazumdar Dr.Kamal Modi Dr Nimmi Kansal

-------------------------------End of report --------------------------------

Name : Ms. SHIVANI BHATT

Test Name Results Units Bio. Ref. Interval

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