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9 Leino
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Abstract
Background: The stability of analyte concentrations in plasma after prolonged contact with blood cells in uncentrifuged
lithium-heparin gel tubes was studied.
Methods: To investigate the stability of concentrations of 26 chemistry and 15 immunochemistry analytes, the simultaneously
drawn samples (n ¼ 50) were measured after 6 h storage at þ88C and þ228C in whole blood and after immediate separation of
plasma. The analyte concentrations were measured with a Roche Modular PPEE analyser using reagents from Roche Diagnostics.
Results: After prolonged contact with cells a clinically significant change was only observed for potassium where the mean value
increased from 4.0 mmol/L to 4.8 mmol/L (P , 0.001) when stored at þ88C.
Conclusion: Immediate separation of plasma from cells is recommended. However, when prolonged contact of plasma with cell
is unavoidable, samples can be kept uncentrifuged for up to 6 h at þ88C or at þ228C. The stability of potassium, however,
is temperature-dependent and cannot be measured from refrigerated blood samples.
(target mean most closely matched the 0.5 h mean) observed were stored uncentrifuged for 6 h either at þ228C or þ88C.
for the last 12 months for each respective analyte.5 SCL was Only for potassium did the observed mean exceeded the
calculated by establishing the range (+2.8 USD) from mean SCL, increasing from 4.0 mmol/L to 4.8 mmol/L (P ,
at 0.5 h. 0.001) when stored at þ88C. This is known to be due to the
Naþ, Kþ-ATPase activity brought about by cold.6 Our
results are in accordance with the recently published study
Results and discussion of Tanner et al.7 although their findings are based on serum.
Table 1 shows the statistics for plasma analyte concentrations In order to study the effect of transportation (courier or
obtained in samples separated immediately after collection, bus) on the stability of analyte concentrations, the con-
along with those of 6 h storage as whole blood. The results ditions were simulated by strong-handed manipulation of
indicate that the concentrations of 25 chemical and 15 the tubes. Neither the continuous gentle swinging in a
immunochemical analytes were quite stable when samples mixer nor substantial upside down turning of the
SCL, significant change limit; USD, usual standard deviation; ALP, alkaline phosphetase; ALB, albumin; ALp, alanine transaminase; AMYL, amylase; BIL, billrubin;
Ca, calcium; CK, creatinine kinase; CI, chloride; CRP, c-reactive protein; Fe, iron; GGT, gamma glutamyl transferase; HAPTO, haptoglobin; K, potassium; CHOL,
cholesterol; CREA, creatinine; LDH, lactate hydrogenase; Mg. magnesium; Na, sodium; PHOS, inorganic phosphate; RF, rheumatoid factor; TRANSF, transferrin;
TfR, transferrin receptor; TG, triglycerides; UA, uric acid; BUN, urea; B12, vitamin B12; CEA, carcino embryonal antigen; C-PEPT, C-peptide; INSU, insulin;
CORSOL, cortisol; PTH, parathormone; PSA, prostate specific antigen; FPSA, free PSA; TnT, troponin T; TSH, thyroid-stimulating hormone; FT4, free T4
Range of results from 0.5 h concentration at þ228C (n ¼ 50)
†
Means of results (n ¼ 50)
‡
Mean at 0.5 h+2.8 USD
§
Statistically significant difference from 0.5 h concentration (one-way analysis of variance or Kruskal-Wallis test, P , 0.05)
SCLs have been exceeded
Leino and Koivula. Chemical and immunochemical analytes in uncentrifuged plasma samples 161
................................................................................................................................................
uncentrifuged tubes during the prolonged storage had an 3 van Eijsden M, van der Wal MF, Hornstra G, Bousel GJ. Can whole-blood
additional effect on measured concentrations of analytes. samples be stored over 24 hours without compromising stability of
C-reactive protein, retinol, ferritin, folic acid, and fatty acids in
Our results indicate that in the case when lithium-heparin epidemiologic research? Clin Chem 2005;51:230 –2
plasma specimens cannot be separated after collection, the 4 Jensen EA, Stahl M, Brandslund I, Grinsted P. Stability of heparin blood
storage either at þ228C or þ88C up to the 6 h can be samples during transport based on defined pre-analytical quality goals.
allowed since most concentrations of analytes were suffi- Clin Chem Lab Med 2008;46:225 –34
5 Passey RB. Quality control for clinical chemistry laboratory. In: Kaplan
ciently stable when compared with those immediately
LA, Pesce JA, eds. Clinical Chemistry: Theory, Analysis, and Correlation. 3rd
separated from cells. The stability of potassium, however, edn. St Louis: CV Mosby Company, 1996:385– 91
is temperature-dependent and cannot be measured from 6 Jandi JH. Physilogy of red cells. In: Jandi JH, ed. Blood: Textbook of
refridgerated blood specimen. Hematology. 2nd edn. Boston, USA: Little Brown and Company,
1996:157– 77
7 Tanner M, Kent N, Smith B, Fletcher S, Lewer M. Stability of common
REFERENCES biochemical analytes in serum gel tubes subjected to various storage
temperatures and times pre-centrifugation. Ann Clin Biochem
1 Boyanton BL Jr, Blick KE. Stability studies of twenty-four analytes in 2008;45:375 –9
human plasma and serum. Clin Chem 2002;48:2242 –7
2 Clark S, Youngman LD, Palmer A, Parish S, Peto R, Collins R. Stability of
plasma analytes after delayed separation of whole blood: implications for
epidemiological studies. Int J Epidemiol 2003;32:125 –30 (Accepted 21 November 2008)