Impact of Centrifugation Time Reduction in GLP Systems.
Author(s): Choosongsang P., Yamsuwan Y, Petchaithong S, Prasangsab T, Bhornsrivathanyou N, Choosongsang P
Publication: EJIFCC, 2025, Vol. 36, Page 343-365
PubMed ID: 41098227 PubMed Review Paper? No
Purpose of Paper
This study compared levels of 30 clinical chemistry and 9 immunological analytes as well as hemolysis, icterus and lipemia in lithium heparin plasma obtained from blood collected in Vacutainer and Vacuette tubes that were centrifuged using the tube type-specific recommended protocol (1300 g for 10 min and 2200 g for 10 min, respectively) and those centrifuged at 2700 g for 5 or 7 min.
Conclusion of Paper
Although many statistically significant differences were observed when lithium heparin Vacutainer and Vacuette tubes were centrifuged at 2700 g for 5 min or 7 min instead of the manufacturer recommended protocol (1300 g for 10 min and 2200 g for 10 min, respectively), the only difference that exceed the >5% total allowable error was the decrease in lactate dehydrogenase (LDH) in both tube types when centrifuged at 2700 g for 5 min. Levels of all analytes were very strongly correlated between the tube that was centrifuged using the recommended protocol and the tubes centrifuged at 2700 g for 5 or 7 min (R≥0.95, all) for both tube types. The authors conclude that centrifugation at 2700 g for 7 min is acceptable for lithium heparin Vacuette and Vacutainer tubes, although centrifugation of either tube type t at 2700 g for 5 min should be avoided when LDH analysis is anticipated.
Studies
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Study Purpose
This study compared levels of 30 clinical chemistry and 9 immunological analytes as well as the degree of hemolysis, icterus and lipemia in plasma obtained from blood collected in Vacutainer and Vacuette tubes centrifuged using the recommended protocol (1300 g for 10 min and 2200 g for 10 min, respectively) and those centrifuged at 2700 g for 5 and 7 min. Leftover lithium heparin blood from 40 patients (diagnosis not specified) was pooled by blood group (A, B, AB and O) and then divided into three plastic lithium heparin Vacutainer tubes and three plastic lithium heparin Vacuette tubes. Matched tubes were centrifuged using the following protocols: (1.) the tube-type specific recommended protocol of 10 min at 1300 g (Vacutainer tubes) or 10 min at 2200 g (Vacuette tubes), (2.) 7 min at 2700 g (both Vacutainer and Vacuette tubes), and (3.) 5 min at 2700 g (both Vacutainer and Vacuette tubes). Levels of 30 clinical chemistry and 9 immunological analytes as well as the degree of hemolysis, icterus and lipemia were analyzed using Alinity ci analyzers. Acceptable coefficient of variance was defined as one third of the total allowable error as defined by the Spanish Society of Clinical Chemistry and Molecular Pathology (lipase, prostate specific antigen, and cancer antigen 19-9 (CA 19-9)) or CLIA (all other analytes). Relative to the control (the tube centrifuged using the recommended protocol), the percent difference was calculated and considered to be acceptable when it fell within <=95% of the acceptable total allowable error.
Summary of Findings:
In lithium heparin plasma from Vacutainer tubes, plasma that was centrifuged at 2700 g for 5 min had higher levels of albumin, total bilirubin, cholesterol, creatinine, low-density lipoprotein (LDL), Troponin I (TNI), total protein, unsaturated iron-binding capacity (UIBC), high-density lipoprotein (HDL), and urea nitrogen (BUN) and lower calcium, chloride, gamma-glutamyl transferase (GGT), glucose, lactate dehydrogenase (LDH), sodium, triglycerides, N-terminal pro B-type natriuretic peptide (NT-proBNP) than lithium heparin plasma processed using the Vacutainer recommended centrifugation protocol (1300 g for 10 min); alternatively, centrifugation of the same tube type at 2700 g for 7 min resulted in a significant difference in uric acid, higher creatinine and albumin and lower NT-proBNP, glucose, chloride, direct bilirubin and aspartate aminotransferase (AST) than lithium heparin plasma processed using the Vacutainer recommended centrifugation protocol (1300 g for 10 min). Compared to lithium heparin plasma processed using the Vacuette-recommended protocol (2200 g for 10 min), lithium heparin plasma from Vacuette tubes centrifuged at 2700 g for 5 min had higher levels of albumin, alkaline phosphatase (ALP), cancer antigen 125 (CA-125), cholesterol, LDL, LDH, total protein, UIBC, HDL, BUN and lower direct bilirubin, total bilirubin, glucose, phosphorus, triglycerides, and uric acid; lithium heparin plasma from Vacuette tubes that were centrifuged at 2700 g for 7 min had higher albumin, AST, cholesterol, LDL, total protein, and HDL and lower total bilirubin. Notably, only the decrease in LDH exceeded the >5% of the total allowable error when Vacuette or Vacutainer tubes were centrifuged at 2700 g for 5 min; although all remaining differences were statistically significant. For a given tube type, levels of all analytes were very strongly correlated between the tubes centrifuged using the recommended protocol and those centrifuged at 2700 g for 5 or 7 min (R≥0.95, all). The authors conclude that centrifugation at 2700 g for 7 min is acceptable for lithium heparin Vacuette and Vacutainer tubes, although centrifugation of either tube type t at 2700 g for 5 min should be avoided when LDH analysis is anticipated.
Biospecimens
Preservative Types
- None (Fresh)
Diagnoses:
- Not specified
Platform:
Analyte Technology Platform Carbohydrate Clinical chemistry/auto analyzer Electrolyte/Metal Clinical chemistry/auto analyzer Glycoprotein Clinical chemistry/auto analyzer Small molecule Clinical chemistry/auto analyzer Peptide Clinical chemistry/auto analyzer Protein Clinical chemistry/auto analyzer Steroid Clinical chemistry/auto analyzer Lipid Clinical chemistry/auto analyzer Pre-analytical Factors:
Classification Pre-analytical Factor Value(s) Biospecimen Aliquots and Components Centrifugation Multiple speeds compared
Multiple durations compared
Biospecimen Acquisition Type of collection container/solution Lithium heparin Vacutainer
Lithium heparin Vacuette