Pathology Handbook



Ciclosporin, Cyclosporine A

Clinical Indications

Therapeutic drug monitoring of patients on cyclosporin after transplant surgery.

Sub-therapeutic levels may result in organ rejection and high levels in renal damage.

In patients on long-term follow-up, it is important to use the same assay on each occasion - we must therefore be told where the patient had their transplant done so that the samples can be sent to the appropriate laboratory.

Levels are also of value in patients on cyclosporin for myeloproliferative disease.

Request Form

Request on ICE

Give details of WHERE the patient had their transplant so that samples can be sent to the most appropriate reference laboratory


On request

Specific Criteria

Monitoring of patients on cyclosporin therapy

Patient Preparation

Samples should be collected before next dose (trough)

Turnaround Time

5 days


Whole blood in Biochemistry EDTA tube


1 ml


Vacutainer lemon top

Laboratory handling

Sent to referral laboratory; the laboratory used depends on where the patient received their transplant as results are not always transferable between different laboratories.

Causes for Rejection

Unlabelled sample.

Reference Range

Therapeutic range varies depending on reasons for use, type and age of transplant, and concomitant disease and medication.  Renal and liver function should also be monitored.

Therapeutic range 100 - 300 ng/mL. Potentially toxic >400 ng/mL