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AST SoP
AST SoP
Title:
ASPARTATE AMINOTRANSFERASE (AST) TEST SOP
Approved by: Date Approved:
ERIC OSEKRE ADJEI 10th May, 2022
Distribution:
Clinical Biochemistry A&E laboratory
Date of
Discontinuation:
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2. PRINCIPLE
The Vitros AST Slide is a multilayered, analytical element coated on a polyester
support.
A drop of patient sample is deposited on the slide and is evenly distributed by the
spreading layer to the underlying layers. In the assay for aspartate aminotransferase,
the amino group of L-aspartate is transferred to α-ketoglutarate in the presence of
pyridoxal-5-phosphate (P-5-P) to produce glutamate and oxaloacetate. The
oxaloacetate formed in the deamination of the L-aspartate is converted to pyruvate
and carbon dioxide by oxaloacetate decarboxylase. Pyruvate is oxidized to
acetylphosphate and hydrogen peroxide by pyruvate oxidase.
The final reaction step involves the peroxidase-catalyzed oxidation of a leuco dye to
produce a colored dye. The rate of oxidation of the leuco dye is monitored by
reflectance spectrophotometry. The rate of change in reflectance density is
proportional to enzyme activity in the sample. The low wavelength cutoff filter on
the slide support minimizes the blank rate effects of incident light during the dye
development.
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4. DEFINITION OF TERMS
ABBREVIATION FULL NAME
CLSI Clinical & Laboratory Standards Institute
LHIMS Lightwave Hospital Information Management System
AST Aspartate AminoTransferase
5. PERFORMANCE CHARACTERISTICS
See Manufacturer SOP attached
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Other Ingredients
The slide cartridge must reach room temperature, 18–28 °C (64–82 °F),
IMPORTANT:
before it is unwrapped and loaded into the slide supply.
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Note: Load the cartridges within 24 hours after they reach room
temperature, 18–28 °C (64–82 °F).
7. EQUIPMENT
a. VITROS 5600 analyzer
b. Heraeus Megafuge 8 Centrifuge
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9. SAFETY PRECAUTIONS
Lab coat and gloves should be worn during the procedure.
Take care when handling materials and samples of human origin. Since no test method can
offer complete assurance that infectious agents are absent, consider all clinical specimens,
controls, and calibrators potentially infectious. Handle specimens, solid and liquid waste, and
test components in accordance with local regulations and CLSI Guideline M29 or other
published biohazard safety guidelines
10. PROCEDURE
Materials required
VITROS Chemistry Products AST Slides
VITROS Chemistry Products Calibrator Kit 3
Quality control materials, such as VITROS Chemistry Products Performance Verifier I
and II
VITROS Chemistry Products 7% BSA
VITROS Chemistry Products FS Diluent Pack 2 (BSA/Saline) (for on-analyzer dilution)
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11. RESULTS
Reporting Units - The VITROS Chemistry System may be programmed to report
AST results in conventional or SI units.
U/L
µkat/L (U/L x 0.0167)
12. NOTES
Bring all fluids and samples to room temperature, 18–28 °C (64–82 °F), prior to
analysis.
Verify performance of reagents with quality control materials:
If the system is turned off for more than 2 hours.
After reloading cartridges that have been removed from the slide supply and
stored for later use.
Check reagent inventories at least daily to ensure that quantities are sufficient for the
planned workload.
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14. PRECAUTIONS
a. Do not draw specimen from an arm receiving an intravenous transfusion.
b. Fibrin clots may cause incomplete sampling of the specimen.
Allow specimens to clot completely in order to prevent fibrin clots.
Inspect plasma specimens for fibrin clots.
c. Centrifuge specimens and remove the serum or plasma from the cellular
material within 2 hours of collection
d. Avoid agitation or mixing of plasma samples after centrifugation. Re-
suspension of platelets into previously centrifuged plasma may lead to
artificially elevated AST results because of high AST activity in platelets.
e. Centrifuge specimens and remove the serum or plasma from the cellular
material within 3 days of collection.
Known Interferences
* It is possible that other interfering substances may be encountered. These results are
representative; however, your results may differ somewhat due to test-to-test variation.
The degree of interference at concentrations other than those listed might not be
predictable.
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Other Interferences
High levels of pyruvate will trigger either TR or DP flags. Such samples need to be
repeated following dilution.
Certain drugs and clinical conditions are known to alter aspartate aminotransferase
activity in vivo. For additional information, refer to one of the published summaries.
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18. REFERENCES
Doumas BT, et al. Differences Between Values for Plasma and Serum in Tests Performed
in the Ektachem 700 XR Analyzer, and Evaluation of “Plasma Separator Tubes (PST).”
Clin. Chem. 35:151–153; 1989.
CLSI. Collection of Diagnostic Venous Blood Specimens. 7th ed. CLSI standard GP41.
Wayne, PA: Clinical and Laboratory Standards Institute; 2017.
NCCLS. Procedures and Devices for the Collection of Diagnostic Capillary Blood
Specimens; Approved Standard—Fifth Edition. NCCLS document H4-A5 [ISBN 1-56238-
538-0]. CLSI, 940 West Valley Road, Suite 1400, Wayne, PA 19087-1898 USA; 2004.
Clinical Laboratory Handbook for Patient Preparation and Specimen Handling. Fascicle
VI: Chemistry/Clinical Microscopy. Northfield, IL: College of American Pathologists;
1992.
NCCLS. Interference Testing in Clinical Chemistry. NCCLS Document EP7. CLSI, 940
West Valley Road, Suite 1400, Wayne, PA 19087-1898 USA; 1986.
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APPENDIX
USER LOG SHEET
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