1
|
Padalko E, Colenbie L, Delforge A, Ectors N, Guns J, Imbert R, Jansens H, Pirnay JP, Rodenbach MP, Van Riet I, Vansteenbrugge A, Verbeken G, Baltes M, Beele H. Preanalytical variables influencing the interpretation and reporting of biological tests on blood samples of living and deceased donors for human body materials. Cell Tissue Bank 2024; 25:509-520. [PMID: 37624485 PMCID: PMC11143040 DOI: 10.1007/s10561-023-10106-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 07/22/2023] [Indexed: 08/26/2023]
Abstract
With the present paper, the Working Group on Cells, Tissues and Organs and other experts of the Superior Health Council of Belgium aimed to provide stakeholders in material of human origin with advice on critical aspects of serological and nucleic acid test (NAT) testing, to improve virological safety of cell- and tissue and organ donation. The current paper focusses on a number of preanalytical variables which can be critical for any medical biology examination: (1) sampling related variables (type of samples, collection of the samples, volume of the sample, choice of specific tubes, identification of tubes), (2) variables related to transport, storage and processing of blood samples (transport, centrifugation and haemolysis, storage before and after centrifugation, use of serum versus plasma), (3) variables related to dilution (haemodilution, pooling of samples), and (4) test dependent variables (available tests and validation). Depending on the type of donor (deceased donor (heart-beating or non-heart beating) versus living donor (allogeneic, related, autologous), and the type of donated human material (cells, tissue or organs) additional factors can play a role: pre- and post-mortem sampling, conditions of sampling (e.g. morgue), haemodilution, possibility of retesting.
Collapse
Affiliation(s)
- Elizaveta Padalko
- Department of Medical Microbiology, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium.
- Department of Diagnostic Sciences, Ghent University, C. Heymanslaan 10, 9000, Ghent, Belgium.
- Working Group on Cells, Tissues and Organs of the Superior Health Council, Brussels, Belgium.
| | - Luc Colenbie
- Working Group on Cells, Tissues and Organs of the Superior Health Council, Brussels, Belgium
- Department of Transplant Center, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Alain Delforge
- Working Group on Cells, Tissues and Organs of the Superior Health Council, Brussels, Belgium
- Laboratory of Clinical Cellular Therapy, Institute J. Bordet, Rue Meylemeersch 90, 1070, Brussels, Belgium
| | - Nadine Ectors
- Working Group on Cells, Tissues and Organs of the Superior Health Council, Brussels, Belgium
- Faculty of Medicine, KU Leuven (Catholic University of Leuven), Oude Markt 13, 3000, Leuven, Belgium
| | - Johan Guns
- Working Group on Cells, Tissues and Organs of the Superior Health Council, Brussels, Belgium
- Department of Laboratory Quality, Free University of Brussels VUB/University Hospital, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Romain Imbert
- Working Group on Cells, Tissues and Organs of the Superior Health Council, Brussels, Belgium
- Department of Medically Assisted Reproduction, CHIREC, Boulevard du Triomphe 201, 1160, Brussels, Belgium
| | - Hilde Jansens
- Working Group on Cells, Tissues and Organs of the Superior Health Council, Brussels, Belgium
- Department of Medical Microbiology, Antwerp University/University Hospital, Drie Eikenstraat 655, 2650, Edegem, Belgium
| | - Jean-Paul Pirnay
- Working Group on Cells, Tissues and Organs of the Superior Health Council, Brussels, Belgium
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, B-1120, Brussels, Belgium
| | - Marie-Pierre Rodenbach
- Working Group on Cells, Tissues and Organs of the Superior Health Council, Brussels, Belgium
- Service du Sang, Croix-Rouge de Belgique, Rue du Fond du Maréchal 8, 5021, Suarlée, Belgium
| | - Ivan Van Riet
- Working Group on Cells, Tissues and Organs of the Superior Health Council, Brussels, Belgium
- Department of Hematology, University Hospital Brussels (UZ Brussel), Jette, Belgium
| | - Anne Vansteenbrugge
- Working Group on Cells, Tissues and Organs of the Superior Health Council, Brussels, Belgium
- Department of Medically Assisted Reproduction, CHIREC, Boulevard du Triomphe 201, 1160, Brussels, Belgium
| | - Gilbert Verbeken
- Working Group on Cells, Tissues and Organs of the Superior Health Council, Brussels, Belgium
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Bruynstraat 1, B-1120, Brussels, Belgium
| | - Muriel Baltes
- Working Group on Cells, Tissues and Organs of the Superior Health Council, Brussels, Belgium
| | - Hilde Beele
- Working Group on Cells, Tissues and Organs of the Superior Health Council, Brussels, Belgium
- Department of Dermatology, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| |
Collapse
|
2
|
Valcke B, Vercauteren K, Padalko E, Verhofstede C, D'Herde K, Willaert W. Screening algorithms for HBV, HCV, HIV and syphilis in an anatomical donation program. Ann Anat 2021; 239:151805. [PMID: 34265386 DOI: 10.1016/j.aanat.2021.151805] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Users of anatomical donors are at risk of exposure to bloodborne pathogens. This study evaluated screening algorithms for hepatitis B and C virus, human immunodeficiency virus and Treponema pallidum during donor allocation and assessed the impact of postmortem time on hemolysis and how hemolysis affects test results and donor discard rate. METHODS From 2011 to 2018, demographic data of anatomical donors, time of postmortem blood sampling, presence of sample hemolysis, serological test results (negative; active infection; false reactive screening test; historic infection; inconclusive; technically impracticable) and the actual donor allocation were collected. RESULTS Donors (n = 537) had a mean age of 77.53 ± 13.67 (24-103) year. Nine (1.68%) had laboratory test results indicative for active infection for hepatitis B (n = 1) and C virus (n = 2), human immunodeficiency virus (n = 5) and T. pallidum (n = 1). Negative screenings ranged from 74.67 to 97.58%, depending on the pathogen. According to the original screening algorithms, 479 (89.20%) donors should have been accepted. In practice, a donor acceptance rate of 91.20% was found. Analysis of potential donor allocation interpretation obstacles resulted in simplification of the in-house laboratory testing algorithms and addition of a nucleic acid test to increase the reliability for identification of active (acute) human immunodeficiency virus infection. Hemolysis was more common when sampling was performed more than 24 h after death (p < 0.001). Hemolytic samples more frequently showed a reactive or indeterminate human immunodeficiency virus test result (p < 0.001). Screening for human immunodeficiency virus and T. pallidum was technically more impracticable when hemolysis was present (p = 0.042 and p = 0.003, respectively). Donors with hemolytic blood samples were more often discarded (46.88%) compared to bodies with non-hemolytic samples (6.32%) (p < 0.001). CONCLUSIONS Despite the implementation of donor screening algorithms, a significant number of bodies have an inconsistent allocation. New algorithms, to be evaluated in future research, were suggested. Early postmortem blood sampling is key as hemolysis can influence certain test results and donor allocation.
Collapse
Affiliation(s)
- Brecht Valcke
- Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Koen Vercauteren
- Clinical Virology Unit, Clinical Reference Laboratory, Institute of Tropical Medicine, Kronenburgstraat 43, 2000 Antwerp, Belgium
| | - Elizaveta Padalko
- Laboratory of Medical Microbiology, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Chris Verhofstede
- Aids Reference Laboratory, Department of Diagnostic Sciences, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Katharina D'Herde
- Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Wouter Willaert
- Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
| |
Collapse
|
3
|
Dwivedi V, Yaniv K, Sharon M. Beyond cells: The extracellular circulating 20S proteasomes. Biochim Biophys Acta Mol Basis Dis 2020; 1867:166041. [PMID: 33338594 DOI: 10.1016/j.bbadis.2020.166041] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/30/2020] [Accepted: 12/04/2020] [Indexed: 01/08/2023]
Abstract
Accumulating evidence arising from numerous clinical studies indicate that assembled and functional 20S proteasome complexes circulate freely in plasma. Elevated levels of this core proteolytic complex have been found in the plasma of patients suffering from blood, skin and solid cancers, autoimmune disorders, trauma and sepsis. Moreover, in various diseases, there is a positive correlation between circulating 20S proteasome (c20S) levels and treatment efficacy and survival rates, suggesting the involvement of this under-studied c20S complex in pathophysiology. However, many aspects of this system remain enigmatic, as we still do not know the origin, biological role or mechanisms of extracellular transport and regulation of c20S proteasomes. In this review, we provide an overview of the current understanding of the c20S proteasome system and discuss the remaining gaps in knowledge.
Collapse
Affiliation(s)
- Vandita Dwivedi
- Departments of Biomolecular Sciences, Weizmann Institute of Science, Rehovot 7610001, Israel
| | - Karina Yaniv
- Departments of Biological Regulation, Weizmann Institute of Science, Rehovot 7610001, Israel
| | - Michal Sharon
- Departments of Biomolecular Sciences, Weizmann Institute of Science, Rehovot 7610001, Israel.
| |
Collapse
|
4
|
Verougstraete N, Padalko E, Coorevits L. Interpretation of EBV serology for human body material donors: Is there a need for early antigen IgG and heterophile antibodies testing? Cell Tissue Bank 2019; 21:167-169. [PMID: 31838726 DOI: 10.1007/s10561-019-09802-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 12/04/2019] [Accepted: 12/09/2019] [Indexed: 10/25/2022]
Abstract
In this report we evaluated a diagnostic algorithm, proposed by the Belgian Superior Health Council, to detect acute and past Epstein-Barr virus (EBV) infections by means of serology in donors of human body material for transplantation. The available EBV serology parameters were tested on eighty serum samples on three random access analysers: Architect i2000 SR, Liasion XL and BioPlex 2200. The EBV sero-status was determined according to the proposed algorithm and results were compared between the different analysers. Seventy one % of the samples gave concordant interpretations on the three analysers. Most of the discordant results were attributable to early antigen (EA) IgG. The knowledge of the EA IgG and heterophile antibodies (HA) IgM status provided only limited added value and was only useful to distinguish between a very early acute infection and false positivity of viral capsid antigen IgM. The diagnostic algorithm proposed by the Belgian Superior Health Council is merely directive and each individual lab remains responsible for the interpretation and implementation of test combinations for the detection of EBV infections. Our study shows the limited added value of testing for EA IgG and HA IgM, based both on clinical and technical performance.
Collapse
Affiliation(s)
- Nick Verougstraete
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium.
| | - Elizaveta Padalko
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Liselotte Coorevits
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium
| |
Collapse
|