Sample laboratory tests for monitoring after lung transplantation

CBC and differential

CD3 cell count*

Electrolytes (including calcium and magnesium)

Glucose

BUN, creatinine

AST, ALT, alkaline phosphatase, bilirubin

Lipid panel

CMV PCR

Drug levels^¶

Cyclosporine trough or C2^Δ

Tacrolimus trough

Everolimus trough

Sirolimus trough

The above table is a sample list. Each transplant center develops its own routine regarding the specific tests to monitor and their frequency, which is then adjusted for each patient based on symptoms, prior results, and immunosuppression regimen.

CBC: complete blood count; BUN: blood urea nitrogen; AST: aspartate aminotransferase (formerly SGOT); ALT: alanine aminotransferase (formerly SGPT); C2: cyclosporine level two hours post dose; CMV: cytomegalovirus; PCR: polymerase chain reaction.
* CD3 cell counts are monitored initially following induction therapy with a polyclonal agent or alemtuzumab, but not on an ongoing basis.
¶ Drug levels are guided by the individual patient's drug regimen. Examples are given in the table.
Δ When monitoring cyclosporine, trough levels are used by most centers, although C2 levels are felt to be more accurate.

Graphic 83298 Version 4.0

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Sample laboratory tests for monitoring after lung transplantation