Comparative evaluation of two different blood collection tubes for hematological and biochemical testing.
Author(s): Salvatici M, Carreras F, Gaimarri M, Sansico FD, Marinoni P, Masserini C, Bianchi B, Sommese C, Drago L
Publication: Pract Lab Med, 2026, Vol. 48, Page e00515
PubMed ID: 41503055 PubMed Review Paper? No
Purpose of Paper
This paper compared levels of hematological and biochemical analytes in case-matched leftover blood specimens stored in K2EDTA and serum separator gel tubes from two different manufacturers (BD and Disera). Blood from two different collection sites was stored at room temperature or 4 °C for up to 24 h, but comparisons were restricted to between tube manufacturer for a given timepoint. As blood collected at one site required transport, the effects of specimen transport were indirectly investigated by comparing results obtained at the two sites.
Conclusion of Paper
While statistically significant differences in levels of individual analytes were found between case-matched specimens stored in Disera Vacusera and BD vacutainer tubes at specific storage timepoints, none of the differences were considered clinically significant. Further, as there was no difference in hemolysis between the two sites or between tube types at any timepoint, the authors concluded that specimen transportation prior to centrifugation had no effect on the analytes evaluated. The authors conclude that the tubes from the two manufacturers are analytically equivalent across the storage conditions and temperatures tested and that transport and storage do not influence hemolysis.
Studies
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Study Purpose
This study compared levels of hematological and biochemical analytes in case-matched leftover blood specimens stored in K2EDTA and serum separator gel tubes from two different manufacturers (BD and Disera). Blood from two different collection sites was stored at room temperature or 4 °C for up to 24 h, but comparisons were restricted to tube type manufacturer for a given timepoint. As blood collected at one site required transport, the effects of specimen transport were indirectly investigated by comparing results obtained for the tubes at the two sites. Leftover blood specimens from 49 patients (diagnosis not specified) at the Castellanza hospital and 46 patients (diagnosis not specified) at the Fantoli MultiLab were divided into matched BD and Disera K2EDTA and serum separator gel tubes. Matched tubes of both types were placed and stored for 0, 1, 3 or 24 h and specimens from Castellanza hospital were transported to the Fantoli MultiLab pre- or post-centrifugation (speed/duration and other details not reported) for analysis. Hemolysis was assessed visually and assayed using an Atellica Solution analyzer. Red blood cell (RBC), white blood cell (WBC) and platelets were enumerated using a XN-9000 analyzer. Levels of potassium (K), chloride (Cl), sodium (Na), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and lactate dehydrogenase (LDH) were assayed using an Atellica Solution analyzer. Differences were only considered clinically significant if the mean bias or limits of agreement (LoA) exceeded the total allowable error for the analyte as outlined by the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM).
Summary of Findings:
Prior to storage, blood in Disera Vacusera tubes collected at the Fentoli Multilab had slightly lower hemoglobin (139.52 versus 144.88 gl/L, P=0.005) and ALT (19.76 versus 21.52 U/L, P=0.0077) levels than case-matched specimens collected in BD Vacutainer tubes at the same location, but none of the differences were considered clinically significant. Blood from the Fentoli Multilab that were stored at room temperature in Disera Vacusera tubes had lower WBC counts after 1 h (6.82 versus 34.42 x 109/L, P=0.0054), K after 1 h (4.304 versus 4.320 mmol/L, P=0.0306) and 3 h (4.308 versus 4.319 mmol/L, P=0.0016 ), Cl after 24 h (105.712 versus 106.24 mmol/L, P=0.0168), Na after 1 h (142.51 versus 143.14 mmol/L, P=0.0035), ALT after 1 h (20.68 versus 22.16, P=0.0488) and AST after 24 h (21.04 versus 21.96 U/L, P=0.0435) than case matched blood from the same site that were stored in BD vacutainer tubes. Blood from the Fantoli Multilab that was stored at 4°C in Disera Vacusera tubes had lower WBC counts (6.446 versus 6.60 x 109/L, P=0.0495), and ALT (24.76 versus 25.86 U/L, P=0.0200) after 24 h than case-matched blood from the same site that were stored for the same duration in BD vacutainer tubes, but none of the biases were considered clinically significant.
At baseline, blood in Disera Vacusera tubes collected at the Castellanza hospital had slightly lower Na (139.20 versus 139.97 mmol/L, P=0.005), K (4.39 versus 4.40 mmol/L, P=0.0310) and LDH (211.15 versus 211. 96 U/L, P=0.0234) levels than case-matched specimens in BD Vacutainer tubes, but none of the differences were considered clinically significant. When stored at room temperature, blood from the Castellanza hospital stored in Disera Vacusera tubes had lower K (4.4111 versus 4.42 mmol/L, P= 0.0096) and Na after 1 h (139.96 versus 140.39 mmol/L, P=0.0068), and 3 h (140.4827 versus 140.960 mmol/L, P=0.0092) and higher hemoglobin after 1 h (124.92 versus 123.1 g/L, P=0.0208 ), AST after 1 h (27.3706 versus 26.7307, P=0.0124) and 3 h (26.923 versus 27.576 U/L, P=0.0054), and higher ALT after 1 h (34.42 versus 35.31 U/L, P=0.0043) than case matched blood also from the Castellanza hospital stored that was stored for the same duration in BD vacutainer tubes, but none of the biases were considered clinically significant. When blood from the from Castellanza hospital was stored at 4°C, specimens stored in Disera Vacusera tubes had lower WBC counts after 1 h (7.27 versus 7.24 x 109/L, P=0.0159), K after 1 (4.38 versus 4.39 mmol/L, P=0.0256) and 3 h (4.38 versus 4.39 mmol/L, P=0.0027), Cl after 1 h (105.19 versus 107.04 mmol/L, P=0.0165), Na after 3 h (142.1 versus 142.72 mmol/L, P=0.0181), and ALT after 3 h (27.09 versus 28.13 U/L, P=0.0288) and higher hemoglobin after 3 h (124.3 versus 122.23 g/L, P=0.0159) than case-matched blood also from the Castellanza hospital that was stored for the same duration in BD vacutainer tubes, but none of the biases were considered clinically significant.
As there was no difference in hemolysis between the two sites or between the tube types from different manufacturers at any timepoint, the authors conclude that centrifugation prior to transport, transportation, and storage did not influence hemolysis. The authors conclude that the tubes from the two manufacturers are analytically equivalent across the storage conditions tested.
Biospecimens
Preservative Types
- None (Fresh)
Diagnoses:
- Not specified
Platform:
Analyte Technology Platform Cell count/volume Hematology/ auto analyzer Electrolyte/Metal Clinical chemistry/auto analyzer Protein Clinical chemistry/auto analyzer Protein Macroscopic observation Protein Hematology/ auto analyzer Pre-analytical Factors:
Classification Pre-analytical Factor Value(s) Biospecimen Acquisition Anticoagulant Multiple manufacturers evaluated
Storage Storage duration 0 h
1 h
3 h
24 h
Storage Storage temperature Room temperature
4°C
Storage Type of storage container Vacutainer tube
Vacusera tube