Transplant Trial Watch

Effects, costs and implementation of monitoring kidney transplant patients' tacrolimus levels with Dried Blood Spot sampling: a randomized controlled hybrid implementation trial

Veenhof, H., et al.

British Journal of Clinical Pharmacology 2020 [record in progress]

The primary objective of study was to examine whether the use of dried blood spot (DBS) home sampling leads to a decrease on the burden of travelling for patients and reduces societal costs.

54 patients were randomized to two groups: the intervention group that received DBS home sampling in addition to usual care, and the control group that received usual care only.

Renal transplant recipients

The primary outcome was the number of outpatient visits per patient. The secondary outcomes were patient satisfaction and costs.

6 months

CET Conclusions
This small single-centre study investigated the use of dried-blood spot (DBS) sampling in the community for patients following renal transplantation. The hypothesis tested was that implementation of DBS would allow results to be available at the time of outpatient consultation, reducing the number of visits required for stable patients. In fact, no difference in number of visits was observed, and the number of required samples received on time was low. However, patients were happy to undertake DBS if it could reduce the number of visits. The technology used here is promising, be the implementation is probably not optimal. DBS may achieve the required reduction in outpatient clinics if combined with other strategies such as telemedicine or video clinics. Clearly logistical issues around the timely deliver of samples to the laboratory would also have to be overcome.

Jadad score

Data analysis
Per protocol analysis

Allocation concealment

Trial registration
Dutch Trial Register (Trial NL7721)

Funding source
Industry & non-industry funded