Stability of 35 biochemical and immunological routine tests after 10 hours storage and transport of human whole blood at 21°C.
Author(s): Henriksen LO, Faber NR, Moller MF, Nexo E, Hansen AB
Publication: Scand J Clin Lab Invest, 2014, Vol. , Page 1-8
PubMed ID: 24988314 PubMed Review Paper? No
Purpose of Paper
The purpose of this paper was to determine the effects of storing whole blood for 10 h at room temperature in lithium heparin or serum tubes prior to centrifugation on the levels of 35 clinical chemistry analytes.
Conclusion of Paper
After delaying centrifugation by 10 h, levels of phosphate increased by 11.2% and folate decreased 13.7%, and these effects were clinically significant. However, statistically significant but clinically irrelevant negative biases were observed when centrifugation was delayed by 10 h in levels of alanine aminotransferase, amylase, creatinine kinase (CK), ferritin, triglycerides, and cobalamin, while positive biases were observed in calcium, cholesterol, c-reactive protein (CRP), free thyroxine (FT4), immunoglobulin A (IgA), immunoglobulin M (IgM), potassium, sodium, orosomucoid, transferrin, uric acid, iron, high density lipoprotein cholesterol (HDL-C) and thyroid stimulating hormone (TSH).
Studies
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Study Purpose
The purpose of this study was to determine the effects of storing and transporting whole blood for 10 h at room temperature in lithium heparin or serum vacutainers prior to centrifugation on the levels of 35 clinical chemistry analytes. Blood from 106 non-fasting hospitalized patients was obtained into two serum and two lithium heparin vacutainers. One tube of each type was centrifuged 30-90 min after blood collection (control), while the others were stored upright at 21 degrees C for 10 h in the dark and transported by car before being centrifuged. After centrifugation, specimens were stored at room temperature for 15 min-3 h in the collection tube, with no protection from light, until analysis. Serum specimens were used for analysis of cobalamin (B12), free triiodothyronine (FT3), FT4, ferritin, folate, prostate specific antigen (PSA) and TSH, while all other analytes were measured in plasma specimens.
Summary of Findings:
Small, clinically insignificant, but statistically significant negative biases in levels of alanine aminotransferase (p=0.0034), amylase (p<0.0001), CK (p=0.0023), ferritin (p=0.039), and tryglycerides (p=0.018) were noted when centrifugation was delayed by 10 h. Positive biases in calcium (p<0.0001), cholesterol (p=0.008), CRP (p=0.046), FT4 (p=0.039), IgA (p<0.0001), IgM (p<0.0001), potassium (p=0.040), sodium (p=0.0003), orosomucoid (p=0.017), transferrin (p<0.0001) and uric acid (p<0.0001) were also noted when centrifugation was delayed by 10 h. Delayed centrifugation resulted in a significant and more pronounced negative bias in levels of cobalamin (p=0.015) and positive biases in levels of iron (p<0.0001), HDL-C (p<0.0001) and TSH (p=0.004), but these biases were still within the authors' goal for imprecision and were clinically insignificant. However, levels of phosphate increased by 11.2% (p<0.0001), and folate decreased 13.7% (p=0.0007) when centrifugation was delayed by 10 h, and these effects were clinically significant. Albumin, antitrypsin, alkaline phosphatase, bilirubin, carbon dioxide, creatinine, free triiodothyronine (FT3), γ-glutamyl transferase (GGT), haptoglobin, immunoglobulin G, lactate dehydrogenase (LD), prostate specific antigen (PSA), and urea were not affected by delayed centrifugation of whole blood.
Biospecimens
Preservative Types
- None (Fresh)
Diagnoses:
- Not specified
Platform:
Analyte Technology Platform Electrolyte/Metal Clinical chemistry/auto analyzer Gas Clinical chemistry/auto analyzer Glycoprotein Clinical chemistry/auto analyzer Steroid Clinical chemistry/auto analyzer Protein Clinical chemistry/auto analyzer Peptide Clinical chemistry/auto analyzer Small molecule Clinical chemistry/auto analyzer Lipid Clinical chemistry/auto analyzer Pre-analytical Factors:
Classification Pre-analytical Factor Value(s) Storage Time at room temperature 30-90 min
10 h
Storage Between site transportation method Not transported
Car/Truck
Biospecimen Aliquots and Components Centrifugation Centrifugation delays investigated