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Pre-analytical stability of haematinics, lactate dehydrogenase and phosphate in whole blood at room temperature up to 24 h, and refrigerated serum stability of lactate dehydrogenase, folate and vitamin B12 up to 72 h using the CRESS checklist

  • Robert Williams , Monika Jankute , Rizwan Ifrahim , Jane Cordle and Sophie Hepburn ORCID logo EMAIL logo
Published/Copyright: December 2, 2024
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 63 Issue 4

Abstract

Objectives

There is a lack of analyte stability data in whole blood (WB). The aim of this study was to determine the allowable delay in WB processing for lactate dehydrogenase (LDH), folate, vitamin B12, iron and phosphate measurement. The stability of LDH, folate and vitamin B12 was also assessed in stored serum at clinically relevant time points.

Methods

Blood was taken from n=10 volunteers into Sarstedt serum gel tubes. We assessed stability in WB at room temperature up to 24 h, and stability in refrigerated serum up to 72 h. Mean percentage deviation at each time point was compared to criteria for minimum allowable bias.

Results

Results produced from one individual were removed due to discordant results, leaving n=9 specimens at each time point. Stability of folate and phosphate was variable in WB across 24 h, but was deemed to be clinically acceptable. LDH was unstable in WB, iron was stable for at least 12 h, and vitamin B12 and ferritin were acceptable for up to 24 h. Serum LDH, folate and vitamin B12 all demonstrated acceptable stability in refrigerated serum stored for up to 72 h.

Conclusions

Blood should ideally be centrifuged within 7 h for phosphate, LDH and folate, and 12 h for iron. However, for phosphate, folate and iron, there is likely to be little clinical impact if serum separation is delayed up to 24 h. Further research is needed to assess LDH stability in WB at 0–12 h, but changes are minimal at 12 h. All other analytes assessed showed acceptable stability across the time-points tested.

Keywords: pre-analytical; stability; whole blood; serum; biochemistry
Corresponding author: Sophie Hepburn, Blood Sciences, NHS Highland, Raigmore Hospital, Old Perth Road, Inverness, Scotland, IV2 3UJ, UK, E-mail:

Acknowledgments

We would like to thank the volunteers that kindly donated blood samples for the study.

  1. Research ethics: Not applicable.

  2. Informed consent: Not applicable.

  3. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission. SH oversaw data analysis and interpretation. RW and SH wrote the first draft of the report, with MJ and RI contributing to the literature review. JC and RI contributed to the concept of the study and carried out laboratory sample analysis. RI performed venous blood sampling of volunteers. All authors approved the final version.

  4. Use of Large Language Models, AI and Machine Learning Tools: None declared.

  5. Conflict of interest: The authors state no conflict of interest.

  6. Research funding: None declared.

  7. Data availability: Not applicable.

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Received: 2024-09-17
Accepted: 2024-11-02
Published Online: 2024-12-02
Published in Print: 2025-03-26

© 2024 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2024-1098
Keywords for this article
pre-analytical; stability; whole blood; serum; biochemistry

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Beyond test results: the strategic importance of metadata for the integration of AI in laboratory medicine
  4. Reviews
  5. Reference, calibration and referral laboratories – a look at current European provisions and beyond
  6. How has the external quality assessment/proficiency testing of semen analysis been developed in the past 34 years: a review
  7. Opinion Papers
  8. Data flow in clinical laboratories: could metadata and peridata bridge the gap to new AI-based applications?
  9. A comprehensive survey of artificial intelligence adoption in European laboratory medicine: current utilization and prospects
  10. Guidelines and Recommendations
  11. Guidelines for the correct use of the nomenclature of biochemical indices of bone status: a position statement of the Joint IOF Working Group and IFCC Committee on Bone Metabolism
  12. Candidate Reference Measurement Procedures and Materials
  13. Absolute quantitation of human serum cystatin C: candidate reference method by 15N-labeled recombinant protein isotope dilution UPLC-MS/MS
  14. General Clinical Chemistry and Laboratory Medicine
  15. Performance evaluation of the introduction of full sample traceability system within the specimen collection process
  16. Pre-analytical stability of haematinics, lactate dehydrogenase and phosphate in whole blood at room temperature up to 24 h, and refrigerated serum stability of lactate dehydrogenase, folate and vitamin B12 up to 72 h using the CRESS checklist
  17. Comparison of capillary finger stick and venous blood sampling for 34 routine chemistry analytes: potential for in hospital and remote blood sampling
  18. Performance evaluation of enzymatic total bile acid (TBA) routine assays: systematic comparison of five fifth-generation TBA cycling methods and their individual bile acid recovery from HPLC-MS/MS reference
  19. Clinical performance of a new lateral flow immunoassay for xylazine detection
  20. Evaluation of revised UK-NEQAS CSF-xanthochromia method for subarachnoid hemorrhage: outcome data provide evidence for clinical value
  21. Strategies to verify equimolar peptide release in mass spectrometry-based protein quantification exemplified for apolipoprotein(a)
  22. Evaluation of the clinical performance of anti-mutated citrullinated vimentin antibody and 14-3-3 eta testing in rheumatoid arthritis
  23. Diagnostic performance of specific biomarkers for interstitial lung disease: a single center study
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  26. Paediatric reference intervals for haematology parameters analysed on Sysmex XN-9000: a comparison of methods in the framework of indirect sampling
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  28. Analytical characteristics and performance of a new hs-cTnI method: a multicenter-study
  29. Diabetes
  30. Use of labile HbA1c as a screening tool to minimize clinical misinterpration of HbA1c
  31. Letters to the Editor
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  34. “Activation” of macro-AST by pyridoxal-5-phosphate in the assay for aspartate aminotransferase
  35. The correlation of albumin with total protein concentrations in cerebrospinal fluid across three automated analysers – relevance to the diagnosis of subarachnoid haemorrhage in clinical chemistry practice
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