Cancer Diagnosis Program | Biorepositories and Biospecimen Research Branch

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Impact of centrifugation time and pneumatic tube transport on plasma concentrations of direct oral anticoagulants.

Author(s): Roginski E, Nissen PH, Hojbjerg JA, Grove EL, Hvas AM

Publication: Int J Lab Hematol, 2022, Vol. 44, Page 216-222

PubMed ID: 34638165 PubMed Review Paper? No

Purpose of Paper

Conclusion of Paper

Studies

1. Study Purpose

   This paper investigated potential effects of different centrifugation protocol and use of pneumatic tube system (PTS) versus bicycle courier transport on quantifiable levels of oral anticoagulants that were spiked into sodium citrate blood specimens immediately after collection. Potential effects of blood specimen transport using a PTS on quantification of oral anticoagulants were also evaluated in blood specimens collected from patients prescribed oral anticoagulants. Blood was collected from healthy volunteers into tubes containing 3.2% sodium citrate. To investigate potential effects of centrifugation protocol, three tubes of blood from each of 10 donors was aliquoted to make 60 samples which were spiked with 30 μg/L or 100 μg/L rivaroxaban, dabigatran, or apixaban (20 aliquots each). Case-matched specimens were then subjected to standard centrifugation at 3163 g for 25 min or 3000 g for 5 min. To investigate potential effects of pneumatic tube transport, blood from 30 healthy blood donors was aliquoted to make 60 samples that were spiked with 30 μg/L or 100 μg/L rivaroxaban, dabigatran, or apixaban (20 aliquots each). Case-matched specimens were then transported by bicycle (690 m) or a pneumatic tube transport system (1010 m at 2.04 m/s). To further investigate the effects of PTS, blood was collected from 10 patients taking rivaroxaban, 9 patients taking apixaban, and 6 patients taking dabigatran; case-matched sodium citrate blood specimens were transported by PTS and bicycle.  Rivaroxaban and apixaban were quantified using chromogenic assays on a Sysmex CS-5100 coagulation analyzer and dabigatran was quantified using a clotting method on the same analyzer.

   Summary of Findings:

   Centrifugation of sodium citrate blood at approximately 3,000 g for 5 min rather than 15 min to obtain plasma resulted in significant bias in quantification of rivaroxaban at both concentrations (bias of 3.8 µg/L at 30 μg/L and bias of 9.5 µg/L at 100 μg/L, P<0.05, both) but did not significantly affect quantification of dabigatran or apixaban. While no effect of blood transport by PTS was observed on specimens spiked with low levels of dabigatran or rivaroxaban, specimens spiked with high levels of dabigatran and rivaroxaban displayed lower quantifiable levels when specimens were transported by PTS than by bicycle (P<0.01, both). However, quantifiable levels of oral anticoagulants did not differ among case-matched specimens collected from patients taking them that were transported manually or by PTS.

   Biospecimens

   • Bodily Fluid - Blood

   Preservative Types

   • None (Fresh)

   Diagnoses:

   • Not specified
   • Normal

   Platform:

   Analyte	Technology Platform
   Small molecule	Clinical chemistry/auto analyzer

   Pre-analytical Factors:

   Classification	Pre-analytical Factor	Value(s)
   Biospecimen Aliquots and Components	Biospecimen components	30 μg/L rivaroxaban 100 μg/L rivaroxaban 30 μg/L dabigatran 100 μg/L dabigatran 30 μg/L apixaban 100 μg/L apixaban
   Biospecimen Aliquots and Components	Centrifugation	Multiple speeds compared Multiple durations compared
   Storage	Within hospital transportation method	Pneumatic tube system Bicycle

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