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Zhao KN, Dimeski G, Masci P, Johnson L, Wang J, de Jersey J, Grant M, Lavin MF. Generation of Rapid and High-Quality Serum by Recombinant Prothrombin Activator Ecarin (RAPClot™). Biomolecules 2024; 14:645. [PMID: 38927049 PMCID: PMC11201583 DOI: 10.3390/biom14060645] [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: 04/08/2024] [Revised: 05/20/2024] [Accepted: 05/20/2024] [Indexed: 06/28/2024] Open
Abstract
We recently reported the potential application of recombinant prothrombin activator ecarin (RAPClot™) in blood diagnostics. In a new study, we describe RAPClot™ as an additive to develop a novel blood collection prototype tube that produces the highest quality serum for accurate biochemical analyte determination. The drying process of the RAPClot™ tube generated minimal effect on the enzymatic activity of the prothrombin activator. According to the bioassays of thrombin activity and plasma clotting, γ-radiation (>25 kGy) resulted in a 30-40% loss of the enzymatic activity of the RAPClot™ tubes. However, a visual blood clotting assay revealed that the γ-radiation-sterilized RAPClot™ tubes showed a high capacity for clotting high-dose heparinized blood (8 U/mL) within 5 min. This was confirmed using Thrombelastography (TEG), indicating full clotting efficiency under anticoagulant conditions. The storage of the RAPClot™ tubes at room temperature (RT) for greater than 12 months resulted in the retention of efficient and effective clotting activity for heparinized blood in 342 s. Furthermore, the enzymatic activity of the RAPClot™ tubes sterilized with an electron-beam (EB) was significantly greater than that with γ-radiation. The EB-sterilized RAPClot™ tubes stored at RT for 251 days retained over 70% enzyme activity and clotted the heparinized blood in 340 s after 682 days. Preliminary clinical studies revealed in the two trials that 5 common analytes (K, Glu, lactate dehydrogenase (LD), Fe, and Phos) or 33 analytes determined in the second study in the γ-sterilized RAPClot™ tubes were similar to those in commercial tubes. In conclusion, the findings indicate that the novel RAPClot™ blood collection prototype tube has a significant advantage over current serum or lithium heparin plasma tubes for routine use in measuring biochemical analytes, confirming a promising application of RAPClot™ in clinical medicine.
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Affiliation(s)
- Kong-Nan Zhao
- Australian Institute of Biotechnology and Nanotechnology, The University of Queensland, Brisbane, QLD 4072, Australia (L.J.); (J.W.)
| | - Goce Dimeski
- Chemical Pathology, Princess Alexandra Hospital, Woolloongabba, Brisbane, QLD 4102, Australia;
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD 4072, Australia;
- School of Medicine, University of Queensland, Brisbane, QLD 4072, Australia
| | - Paul Masci
- Australian Institute of Biotechnology and Nanotechnology, The University of Queensland, Brisbane, QLD 4072, Australia (L.J.); (J.W.)
| | - Lambro Johnson
- Australian Institute of Biotechnology and Nanotechnology, The University of Queensland, Brisbane, QLD 4072, Australia (L.J.); (J.W.)
| | - Jingjing Wang
- Australian Institute of Biotechnology and Nanotechnology, The University of Queensland, Brisbane, QLD 4072, Australia (L.J.); (J.W.)
| | - John de Jersey
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD 4072, Australia;
| | - Michael Grant
- Q-Sera Pty Ltd., Level 9, 31 Queen St, Melbourne, VIC 3000, Australia;
| | - Martin F. Lavin
- Australian Institute of Biotechnology and Nanotechnology, The University of Queensland, Brisbane, QLD 4072, Australia (L.J.); (J.W.)
- Centre for Clinical Research, The University of Queensland, Brisbane, QLD 4029, Australia
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Zhao KN, Masci P, Dimeski G, Johnson L, Grant M, de Jersey J, Lavin MF. Potential Application of Recombinant Snake Prothrombin Activator Ecarin in Blood Diagnostics. Biomolecules 2022; 12:1704. [PMID: 36421717 PMCID: PMC9687618 DOI: 10.3390/biom12111704] [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: 10/05/2022] [Revised: 11/07/2022] [Accepted: 11/10/2022] [Indexed: 08/30/2023] Open
Abstract
We describe here the purification and cloning of a codon-optimized form of the snake prothrombin activator ecarin from the saw scaled viper (Echis carinatus) expressed in mammalian cells. Expression of recombinant ecarin (rEcarin) was carried out in human embryonic kidney cells (HEK) cells under conditions for the development and performance of a novel and scalable recombinant snake ecarin to industry standards. Clotting performance of the rEcarin was established in recalcified citrated whole blood, plasma, and fresh whole blood and found to be comparable to native ecarin (N-Ecarin). Furthermore, hemolysis was observed with N-Ecarin at relatively high doses in both recalcified citrated and fresh whole blood, while clotting was not observed with rEcarin, providing an important advantage for the recombinant form. In addition, rEcarin effectively clotted both recalcified citrated whole blood and fresh whole blood containing different anticoagulants including heparin, warfarin, dabigatran, Fondaparinux, rivaroxaban and apixaban, forming firm clots in the blood collection tubes. These results demonstrate that rEcarin efficiently clots normal blood as well as blood spiked with high concentrations of anticoagulants and has great potential as an additive to blood collection tubes to produce high quality serum for analyte analysis in diagnostic medicine.
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Affiliation(s)
- Kong-Nan Zhao
- Australian Institute of Biotechnology and Nanotechnology, St Lucia Campus, The University of Queensland, Brisbane, QLD 4072, Australia
- Centre for Kidney Disease Research-Venomics Research, School of Medicine, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Paul Masci
- Centre for Kidney Disease Research-Venomics Research, School of Medicine, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Goce Dimeski
- Chemical Pathology, Princess Alexandra Hospital, Woolloongabba, Brisbane, QLD 4102, Australia
- School of Chemistry and Molecular Biosciences, St Lucia Campus, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Lambro Johnson
- Australian Institute of Biotechnology and Nanotechnology, St Lucia Campus, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Michael Grant
- Q-Sera Pty Ltd., Level 9, 31 Queen St, Melbourne, VIC 3000, Australia
| | - John de Jersey
- School of Chemistry and Molecular Biosciences, St Lucia Campus, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Martin F. Lavin
- Australian Institute of Biotechnology and Nanotechnology, St Lucia Campus, The University of Queensland, Brisbane, QLD 4072, Australia
- Centre for Clinical Research, RBWH Campus, The University of Queensland, Brisbane, QLD 4029, Australia
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Dupuy AM, Cau I, Badiou S, Cristol JP. Evaluation of high speed centrifugation for routine biochemistry. Clin Chim Acta 2022; 533:144-147. [PMID: 35779625 DOI: 10.1016/j.cca.2022.06.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Anne Marie Dupuy
- Department of Biochemistry, Indexes Lapeyronie University Hospital, Montpellier, France
| | - Isabelle Cau
- Department of Hematology, Saint Eloi University Hospital, Montpellier, France
| | - Stéphanie Badiou
- Department of Biochemistry, Indexes Lapeyronie University Hospital, Montpellier, France; PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier, Montpellier, France
| | - Jean Paul Cristol
- Department of Biochemistry, Indexes Lapeyronie University Hospital, Montpellier, France; PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier, Montpellier, France.
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Arnold JE, Camus MS, Freeman KP, Giori L, Hooijberg EH, Jeffery U, Korchia J, Meindel MJ, Moore AR, Sisson SC, Vap LM, Cook JR. ASVCP Guidelines: Principles of Quality Assurance and Standards for Veterinary Clinical Pathology (version 3.0): Developed by the American Society for Veterinary Clinical Pathology's (ASVCP) Quality Assurance and Laboratory Standards (QALS) Committee. Vet Clin Pathol 2020; 48:542-618. [PMID: 31889337 DOI: 10.1111/vcp.12810] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
| | - Melinda S Camus
- Department of Pathology, University of Georgia College of Veterinary Medicine, Athens, GA, USA
| | | | - Luca Giori
- Department of Biomedical and Diagnostic Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, USA
| | - Emma H Hooijberg
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
| | - Unity Jeffery
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Jérémie Korchia
- Texas A&M Veterinary Medical Diagnostic Laboratory, College Station, TX, USA
| | | | - A Russell Moore
- Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Sandra C Sisson
- Cornell University College of Veterinary Medicine, Ithaca, NY, USA
| | - Linda M Vap
- Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
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Zhao KN, Dimeski G, de Jersey J, Johnson LA, Grant M, Masci PP, Lavin MF. Rapid serum tube technology overcomes problems associated with use of anticoagulants. Biochem Med (Zagreb) 2019; 29:030706. [PMID: 31624459 PMCID: PMC6784418 DOI: 10.11613/bm.2019.030706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 06/26/2019] [Indexed: 01/18/2023] Open
Abstract
Introduction Failure to obtain complete blood clotting in serum is a common laboratory problem. Our aim was to determine whether snake proth-rombin activators are effective in clotting blood and producing quality serum for analyte measurement in anticoagulated patients. Materials and methods Whole blood clotting was studied in a total of 64 blood samples (41 controls, 20 Warfarin patients, 3 anticoagulated patients using snake venom prothrombin activator (OsPA)) with plain tubes. Coagulation was analysed using a visual assay, Hyland-Clotek and thromboelastography. Healthy control blood was spiked with a range of anticoagulants to determine the effectiveness of OsPa-induced clotting. A paired analysis of a Dabigatran patient and a control investigated the effectiveness of the OsPA clotting tubes. Biochemical analytes (N = 31) were determined for 7 samples on chemistry and immunoassay analysers and compared with commercial tubes. Results Snake venom prothrombin activators efficiently coagulated blood and plasma spiked with heparin and commonly used anticoagulants. Clotting was observed in the presence of anticoagulants whereas no clotting was observed in BDRST tubes containing 3 U/mL of heparin. Snake venom prothrombin activator enhanced heparinised blood clotting by shortening substantially the clotting time and improving significantly the strength of the clot. Comparison of 31 analytes from the blood of five healthy and two anticoagulated participants gave very good agreement between the analyte concentrations determined. Conclusions Our results showed that the snake venom prothrombin activators OsPA and PtPA efficiently coagulated recalcified and fresh bloods with or without added anticoagulants. These procoagulants produced high quality serum for accurate analyte measurement.
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Affiliation(s)
- Kong-Nan Zhao
- Faculty of Medicine, University of Queensland, Translational Research Institute, Brisbane, Australia
| | - Goce Dimeski
- Chemical Pathology, Princess Alexandra Hospital, Brisbane, Australia
| | - John de Jersey
- School of Chemistry and Molecular Biosciences, University of Queensland, Brisbane, Australia
| | - Lambro A Johnson
- Faculty of Medicine, University of Queensland, Translational Research Institute, Brisbane, Australia
| | - Michael Grant
- Q-Sera Pty Ltd, Level 9,31 Queen St, Melbourne, Australia
| | - Paul P Masci
- Faculty of Medicine, University of Queensland, Translational Research Institute, Brisbane, Australia
| | - Martin F Lavin
- Faculty of Medicine, University of Queensland, Translational Research Institute, Brisbane, Australia
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Barricor blood collection tubes are equivalent to PST for a variety of chemistry and immunoassay analytes except for lactate dehydrogenase. Clin Chim Acta 2019; 496:18-24. [PMID: 31201816 DOI: 10.1016/j.cca.2019.06.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 06/10/2019] [Accepted: 06/11/2019] [Indexed: 01/09/2023]
Abstract
INTRODUCTION The BD Barricor tube uses a novel mechanical separator designed to eliminate gel artifacts, decrease cellular contamination, and improve stability. Here, we evaluated the Barricor tube as a possible replacement for PST using Beckman Coulter analyzers under both optimal, alternative, and suboptimal centrifugation conditions based on BD recommendations. METHODS Paired PST and Barricor samples were collected from 4 local hospitals and processed based on site-specific preanalytical systems involving automated or manual centrifugation. Centrifugation conditions ranged from 1912 ×g for 10 min (suboptimal), 2060 g for 10 min (alternative), and 4000 ×g for 3 or 10 min (optimal). Tube volume (4.5 vs. 5.5 ml) was also assessed. Forty-three chemistry and immunochemistry analytes were measured on Beckman Coulter DxC and DxI analyzers. RESULTS Using an automated preanlaytical system with suboptimal spin conditions, no bias between PST and Barricor was observed for all analytes tested except lactate dehydrogenase (LD). Further investigation revealed significant increase in LD when Barricor was spun for 10 min at 1912, 2060 and 4000 ×g, ranging from +7.4-19.4% vs. PST across the entire measurement interval (87-493 U/l). Smaller tube volume was also associated with higher LD. Differences in LD occurred despite no change in other hemolysis markers such as potassium, phosphate, and AST. CONCLUSIONS LD is most sensitive to varying centrifugation conditions (time and speed) in Barricor tubes. We recommend that BD centrifugation protocols should be closely evaluated to determine if Barricor is equivalent to PST under local preanalytical configurations.
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Kristoffersen AH, Stavelin AV, Ajzner E, Kristensen GB, Sandberg S, Van Blerk M, Kitchen S, Kesseler D, Woods TA, Meijer P. Pre-analytical practices for routine coagulation tests in European laboratories. A collaborative study from the European Organisation for External Quality Assurance Providers in Laboratory Medicine (EQALM). ACTA ACUST UNITED AC 2019; 57:1511-1521. [DOI: 10.1515/cclm-2019-0214] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 04/01/2019] [Indexed: 11/15/2022]
Abstract
Abstract
Background
Correct handling and storage of blood samples for coagulation tests are important to assure correct diagnosis and monitoring. The aim of this study was to assess the pre-analytical practices for routine coagulation testing in European laboratories.
Methods
In 2013–2014, European laboratories were invited to fill in a questionnaire addressing pre-analytical requirements regarding tube fill volume, citrate concentration, sample stability, centrifugation and storage conditions for routine coagulation testing (activated partial thromboplastin time [APTT], prothrombin time in seconds [PT-sec] and as international normalised ratio [PT-INR] and fibrinogen).
Results
A total of 662 laboratories from 28 different countries responded. The recommended 3.2% (105–109 mmol/L) citrate tubes are used by 74% of the laboratories. Tube fill volumes ≥90% were required by 73%–76% of the laboratories, depending upon the coagulation test and tube size. The variation in centrifugation force and duration was large (median 2500 g [10- and 90-percentiles 1500 and 4000] and 10 min [5 and 15], respectively). Large variations were also seen in the accepted storage time for different tests and sample materials, for example, for citrated blood at room temperature the accepted storage time ranged from 0.5–72 h and 0.5–189 h for PT-INR and fibrinogen, respectively. If the storage time or the tube fill requirements are not fulfilled, 72% and 84% of the respondents, respectively, would reject the samples.
Conclusions
There was a large variation in pre-analytical practices for routine coagulation testing in European laboratories, especially for centrifugation conditions and storage time requirements.
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Affiliation(s)
- Ann Helen Kristoffersen
- Department of Medical Biochemistry and Pharmacology , Haukeland University Hospital , Bergen , Norway
- Norwegian Quality Improvement of Laboratory Examinations (Noklus) , Haraldsplass Deaconess Hospital , Bergen , Norway
| | - Anne V. Stavelin
- Norwegian Quality Improvement of Laboratory Examinations (Noklus) , Haraldsplass Deaconess Hospital , Bergen , Norway
| | - Eva Ajzner
- Central Laboratory , Jósa University Hospital , Nyíregyháza , Hungary
| | - Gunn B.B. Kristensen
- Norwegian Quality Improvement of Laboratory Examinations (Noklus) , Haraldsplass Deaconess Hospital , Bergen , Norway
| | - Sverre Sandberg
- Department of Medical Biochemistry and Pharmacology , Haukeland University Hospital , Bergen , Norway
- Norwegian Quality Improvement of Laboratory Examinations (Noklus) , Haraldsplass Deaconess Hospital , Bergen , Norway
- Department of Global Public Health and Primary Care , University of Bergen , Bergen , Norway
| | | | - Steve Kitchen
- UK NEQAS for Blood Coagulation , Sheffield , UK
- Sheffield Haemophilia and Thrombosis Centre , Sheffield , UK
| | - Dagmar Kesseler
- Quality Control Center Switzerland (CSCQ) , Chêne-Bourg , Switzerland
| | | | - Piet Meijer
- ECAT foundation , Voorschoten , The Netherlands
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Zhao KN, Dimeski G, de Jersey J, Johnson LA, Grant M, Masci PP, Lavin MF. Next-generation rapid serum tube technology using prothrombin activator coagulant: fast, high-quality serum from normal samples. ACTA ACUST UNITED AC 2018; 57:483-497. [DOI: 10.1515/cclm-2018-0397] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 08/31/2018] [Indexed: 01/30/2023]
Abstract
Abstract
Background
Incomplete blood clotting or latent clotting in serum is a common laboratory problem, especially for patients on anticoagulant therapy or when serum tubes are centrifuged before clotting is completed. We describe a novel approach to producing high-quality serum using snake venom prothrombin activator complex (OsPA) as an additive in blood collection tubes for non-anticoagulated (normal) individuals.
Methods
Plasma clotting assays were performed using a Hyland-Clotek instrument. Blood clotting was visually observed, and thromboelastography was also performed to determine the important parameters of coagulation. Thrombin generation was assayed using the chromogenic substrate S-2238, and biochemical analytes in the serum were determined on chemistry and immunoassay analysers. Fibrinogen was determined by either ELISA or Clauss fibrinogen assay.
Results
We initially showed that OsPA had strong coagulation activity in clotting not only recalcified citrated plasma and recalcified citrated whole blood, but also fresh whole blood in a clinical setting. The use of TEG clearly showed improved speed of clotting and generation of a firmer clot. We also showed that the use of OsPA to produce serum did not interfere with the determination of commonly measured biochemical analytes. The underlying clotting mechanism involves a burst of thrombin production at the initial stages of the clotting process upon contact with prothrombin in blood.
Conclusions
These results demonstrate rapid generation of high-quality serum, contributing to faster turnaround times with standardised quality samples, for accurate analyte determinations in normal individuals.
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Affiliation(s)
- Kong-Nan Zhao
- Centre for Venomics Research, School of Medicine , The University of Queensland, Translational Research Institute , Woolloongabba, QLD , Australia
- Centre for Clinical Research, The University of Queensland, Royal Brisbane and Women’s Hospital Campus , Herston, Brisbane, QLD , Australia
| | - Goce Dimeski
- Chemical Pathology, Princess Alexandra Hospital , Woolloongabba, Brisbane, QLD , Australia
- School of Chemistry and Molecular Biosciences , The University of Queensland, Brisbane , QLD , Australia
| | - John de Jersey
- School of Chemistry and Molecular Biosciences , The University of Queensland, Brisbane , QLD , Australia
| | - Lambro A. Johnson
- Centre for Venomics Research, School of Medicine , The University of Queensland, Translational Research Institute , Woolloongabba, QLD , Australia
| | | | - Paul P. Masci
- Centre for Venomics Research, School of Medicine , The University of Queensland, Translational Research Institute , Woolloongabba, QLD , Australia
- Centre for Clinical Research, The University of Queensland, Royal Brisbane and Women’s Hospital Campus , Herston, Brisbane, QLD , Australia
| | - Martin F. Lavin
- Centre for Clinical Research, The University of Queensland, Royal Brisbane and Women’s Hospital Campus , Herston, Brisbane, QLD 4029 , Australia , Phone: +61 07 3346 6045, Fax: +61 07 3346 5509
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Dimeski G, Johnston J, Masci PP, Zhao KN, Brown N. Evaluation of the Greiner Bio-One serum separator BCA Fast Clot tube. ACTA ACUST UNITED AC 2017; 55:1135-1141. [DOI: 10.1515/cclm-2016-0806] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 11/23/2016] [Indexed: 11/15/2022]
Abstract
Abstract
Background:
Current commercial tubes have difficulties in producing “true” serum from all blood samples even within the recommended clotting times. Hence, Becton Dickinson (BD) and now Greiner have produced tubes containing thrombin as the procoagulant to reduce the clotting time and increase the possibility of producing serum from anticoagulated blood samples.
Methods:
The Greiner BCA Fast Clot (GBBCAFC) tube was evaluated in a hospital environment using 40 participants, (30 healthy and 10 undergoing renal dialysis) for 32 analytes against the Greiner lithium heparin tube and the BD Rapid Serum Tubes (BD RST) tube measured on Beckman DxC 800 and DxI 800 analyzers. Clotting strength was also examined using thromboelastography (TEG).
Results:
The analytes results showed there was a very close agreement between the BD RST tube and GBBCAFC tube in comparison with lithium heparin plasma. The result comparison data showed equivalent performance with lower levels of hemolysis. The prolonged storage study also showed very similar agreement between the BD RST and the GBBCAFC tubes. Likewise, the TEG data showed there was very little difference in clotting ability between the tubes, and neither was capable of producing true serum from blood spiked with 2 U heparin/mL of blood.
Conclusions:
The study showed the GBBCAFC tube with the combination of the two procoagulants blood clotting activator and thrombin produced comparable performance with the lithium heparin plasma and the BD RST serum samples.
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Møller MF, Søndergaard TR, Kristensen HT, Münster AMB. Evaluation of a reduced centrifugation time and higher centrifugal force on various general chemistry and immunochemistry analytes in plasma and serum. Ann Clin Biochem 2016; 54:593-600. [PMID: 27687083 DOI: 10.1177/0004563216674030] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Centrifugation of blood samples is an essential preanalytical step in the clinical biochemistry laboratory. Centrifugation settings are often altered to optimize sample flow and turnaround time. Few studies have addressed the effect of altering centrifugation settings on analytical quality, and almost all studies have been done using collection tubes with gel separator. Methods In this study, we compared a centrifugation time of 5 min at 3000 × g to a standard protocol of 10 min at 2200 × g. Nine selected general chemistry and immunochemistry analytes and interference indices were studied in lithium heparin plasma tubes and serum tubes without gel separator. Results were evaluated using mean bias, difference plots and coefficient of variation, compared with maximum allowable bias and coefficient of variation used in laboratory routine quality control. Results For all analytes except lactate dehydrogenase, the results were within the predefined acceptance criteria, indicating that the analytical quality was not compromised. Lactate dehydrogenase showed higher values after centrifugation for 5 min at 3000 × g, mean bias was 6.3 ± 2.2% and the coefficient of variation was 5%. Conclusions We found that a centrifugation protocol of 5 min at 3000 × g can be used for the general chemistry and immunochemistry analytes studied, with the possible exception of lactate dehydrogenase, which requires further assessment.
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Affiliation(s)
- Mette F Møller
- Department of Clinical Biochemistry, Regional Hospital West Jutland, Herning and Holstebro, Denmark
| | - Tove R Søndergaard
- Department of Clinical Biochemistry, Regional Hospital West Jutland, Herning and Holstebro, Denmark
| | - Helle T Kristensen
- Department of Clinical Biochemistry, Regional Hospital West Jutland, Herning and Holstebro, Denmark
| | - Anna-Marie B Münster
- Department of Clinical Biochemistry, Regional Hospital West Jutland, Herning and Holstebro, Denmark
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Monneret D, Godmer A, Le Guen R, Bravetti C, Emeraud C, Marteau A, Alkouri R, Mestari F, Dever S, Imbert-Bismut F, Bonnefont-Rousselot D. Stability of Routine Biochemical Analytes in Whole Blood and Plasma From Lithium Heparin Gel Tubes During 6-hr Storage. J Clin Lab Anal 2016; 30:602-9. [PMID: 26891785 DOI: 10.1002/jcla.21909] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 09/22/2015] [Accepted: 10/24/2015] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The stability of biochemical analytes has already been investigated, but results strongly differ depending on parameters, methodologies, and sample storage times. We investigated the stability for many biochemical parameters after different storage times of both whole blood and plasma, in order to define acceptable pre- and postcentrifugation delays in hospital laboratories. METHODS Twenty-four analytes were measured (Modular® Roche analyzer) in plasma obtained from blood collected into lithium heparin gel tubes, after 2-6 hr of storage at room temperature either before (n = 28: stability in whole blood) or after (n = 21: stability in plasma) centrifugation. Variations in concentrations were expressed as mean bias from baseline, using the analytical change limit (ACL%) or the reference change value (RCV%) as acceptance limit. RESULTS In tubes stored before centrifugation, mean plasma concentrations significantly decreased after 3 hr for phosphorus (-6.1% [95% CI: -7.4 to -4.7%]; ACL 4.62%) and lactate dehydrogenase (LDH; -5.7% [95% CI: -7.4 to -4.1%]; ACL 5.17%), and slightly decreased after 6 hr for potassium (-2.9% [95% CI: -5.3 to -0.5%]; ACL 4.13%). In plasma stored after centrifugation, mean concentrations decreased after 6 hr for bicarbonates (-19.7% [95% CI: -22.9 to -16.5%]; ACL 15.4%), and moderately increased after 4 hr for LDH (+6.0% [95% CI: +4.3 to +7.6%]; ACL 5.17%). Based on RCV, all the analytes can be considered stable up to 6 hr, whether before or after centrifugation. CONCLUSION This study proposes acceptable delays for most biochemical tests on lithium heparin gel tubes arriving at the laboratory or needing to be reanalyzed.
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Affiliation(s)
- Denis Monneret
- Department of Metabolic Biochemistry, La Pitié Salpêtrière-Charles Foix University Hospital (AP-HP), Paris, France.
| | - Alexandre Godmer
- Department of Metabolic Biochemistry, La Pitié Salpêtrière-Charles Foix University Hospital (AP-HP), Paris, France
| | - Ronan Le Guen
- Department of Metabolic Biochemistry, La Pitié Salpêtrière-Charles Foix University Hospital (AP-HP), Paris, France
| | - Clotilde Bravetti
- Department of Metabolic Biochemistry, La Pitié Salpêtrière-Charles Foix University Hospital (AP-HP), Paris, France
| | - Cecile Emeraud
- Department of Metabolic Biochemistry, La Pitié Salpêtrière-Charles Foix University Hospital (AP-HP), Paris, France
| | - Anthony Marteau
- Department of Metabolic Biochemistry, La Pitié Salpêtrière-Charles Foix University Hospital (AP-HP), Paris, France
| | - Rana Alkouri
- Department of Metabolic Biochemistry, La Pitié Salpêtrière-Charles Foix University Hospital (AP-HP), Paris, France
| | - Fouzi Mestari
- Department of Metabolic Biochemistry, La Pitié Salpêtrière-Charles Foix University Hospital (AP-HP), Paris, France
| | - Sylvie Dever
- Department of Metabolic Biochemistry, La Pitié Salpêtrière-Charles Foix University Hospital (AP-HP), Paris, France
| | - Françoise Imbert-Bismut
- Department of Metabolic Biochemistry, La Pitié Salpêtrière-Charles Foix University Hospital (AP-HP), Paris, France
| | - Dominique Bonnefont-Rousselot
- Department of Metabolic Biochemistry, La Pitié Salpêtrière-Charles Foix University Hospital (AP-HP), Paris, France.,Department of Biochemistry, Faculty of Pharmacy, Paris Descartes University, Paris, France.,UPMC University Paris 6, Paris, France
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Jinks D, Brooks-White R, Bush V. Evaluation of Refrigerated Stability of 15 Analytes in Lithium Heparin Gel Primary Tubes. Lab Med 2013. [DOI: 10.1309/lmhfg0q5eykscldt] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Koenders MMJF, van Hurne MEJF, Glasmacher-Van Zijl M, van der Linde G, Westerhuis BWJJM. The analytic impact of a reduced centrifugation step on chemistry and immunochemistry assays: an evaluation of the Modular Pre-Analytics. Ann Clin Biochem 2012; 49:468-74. [PMID: 22859726 DOI: 10.1258/acb.2012.011233] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The COBAS 6000 system can be completed by a Modular Pre-Analytics (MPA), an integrated laboratory automation system that streamlines preanalysis. For an optimal throughput, the MPA centrifuges blood collection tubes for 5 min at 1885 × g - a centrifugation time that is not in concordance with the World Health Organization guidelines which suggest centrifugation for 10/15 min at 2000-3000 × g. METHODS In this study, the analytical outcome of 50 serum and 50 plasma samples centrifuged for 5 or 10 min at 1885 × g was investigated. The study included routine chemistry and immunochemistry assays on the COBAS 6000 and the Minicap capillary electrophoresis. RESULTS Deming-fit and Bland-Altman plots of the 5-min and 10-min centrifugation steps indicated a significant correlation in serum samples. The lipaemia index in plasma samples centrifuged for 5 min displayed a statistically significant variation when compared with the 10-min centrifugation. CONCLUSIONS Preanalytical centrifugation can be successfully down-scaled to a duration of 5 min for most routine chemistry and immunochemistry assays in serum and plasma samples. To prevent inaccurate results in plasma samples with an increased lipaemia index from being reported, the laboratory information system was programmed to withhold results above certain lipaemia indices. The presented data support the use of a 5-min centrifugation step to improve turnaround times, thereby meeting one of the desires of the requesting clinicians.
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Affiliation(s)
- Mieke M J F Koenders
- Department of Clinical Chemistry & Laboratory Hematology, St Elisabeth Hospital, Hilvarenbeekseweg 60, PO Box 90151, 5000 LC, Tilburg, The Netherlands.
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