Some of the liver transplant patients need to use hepatitis B immunglobulin (HBIG) preparations due to hepatitis B reinfections. Blood level measurement of immunosuppressants used to prevent rejection is performed by immunoassay methods and LC-MS/MS reference method. It is known that immunoassay methods are influenced by immunoglobulins. Therefore, the LC-MS/MS method should be preferred in order to minimize the risk of organ rejection. Although LC-MS/MS is the reference method, some molecules in the serum may cause incorrect measurement of the analyte through matrix effect that is changing ionization efficiency. The aim of this article is to investigate the exposure of immunosuppressant blood level to the matrix effect with HBIG drug used in liver transplant patients Experimentally, it was observed that low and medium blood concentrations of tacrolimus, everolimus, sirolimus and cyclosporin were significantly increased in the interference study by adding HBIG (Hepatect CP 50 IU) to the control materials. Amount of increase is between 15,38% - 35,61%. Incorrect laboratory results may lead clinicians to adjust the wrong blood drug dose. It is vital to keep the immunosuppressive drug levels in the therapeutic index in organ transplant patients. Immunosuppressants should be measured from blood sample that is taken prior to HBIG administration, since incorrect measurements caused by the matrix effect would increase the risk of liver rejection.

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