Lab Med Online.  2011 Apr;1(2):72-80. 10.3343/lmo.2011.1.2.2.

Effects of Long Distance Transportation of Specimens on Test Results

Affiliations
  • 1Department of Laboratory Medicine, Kwandong University College of Medicine, Goyang, Korea. capt95@kd.ac.kr
  • 2Laboratory Medicine and Genetics, Soonchunhyang University Bucheon Hospital and Soonchunhyang University College of Medicine, Bucheon, Korea.
  • 3Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.

Abstract

BACKGROUND
Accuracy of laboratory test results is an important issue. New guidelines for specimen delivery systems are needed for appropriate pretreatment of specimens and accuracy of results.
METHODS
We evaluated various laboratory profiles, comparing the effects of specimen rack holders and coolants within transport containers. The hematology profiles (complete blood cell count [CBC], erythrocyte sedimentation rate [ESR]), chemistry profiles (aspartate aminotransaminase [AST], alanine aminotransaminase [ALT], gamma-glutamyl transferase [gamma-GT], electrolytes [Na, K, Cl], glucose, lactate dehydrogenase [LD], creatinine kinase [CK]), and coagulation profiles (prothrombin time [PT], activated partial thromboplastin time [aPTT], fibrinogen level). We also investigated the effects of transportation time including the presence or absence of hemolyzation. We received from 9 different university hospital laboratories using conventional transporation methods.
RESULTS
Hemolytic features were seen in short drawn specimens. Fewer result variations were observed in specimens transported with coolants. Average specimen transportation time was 11.3 hours, and average temperatures of container was 10.9degrees C with coolant and 25.0degrees C without coolants. Non-centrifuged specimens transported with coolants showed increased serum K levels than centrifuged specimens. Coagulation tests showed less than a 10% differences. Centrifuged specimen prior to transportation showed no hemolyzation and no differences in results.
CONCLUSIONS
Appropriate temperatures for each analyte should be defined to ensure the accuracy of results. To reduce hemolyzation, appropriate temperature and rack holder should be used. Temperature of the transport container should be monitored in objectively. Coagulation tests should be added as referral tests, if appropriate specimen transport monitoring system for time and temperature could be adopted.

Keyword

Specimen delivery; Container; Hemolysis
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