The stability of 65 biochemistry analytes in plasma, serum, and whole blood

Janet Zhou; Anselmo Fabros; Sarah Jane Lam; Anna Coro; Rajeevan Selvaratnam; Davor Brinc; Ashley Di Meo

doi:10.1515/cclm-2023-1192

The stability of 65 biochemistry analytes in plasma, serum, and whole blood

Clin Chem Lab Med. 2024 Mar 7. doi: 10.1515/cclm-2023-1192. Online ahead of print.

Authors

Janet Zhou¹, Anselmo Fabros², Sarah Jane Lam², Anna Coro², Rajeevan Selvaratnam^{1

2}, Davor Brinc^{1

2}, Ashley Di Meo^{1

2}

Affiliations

¹ Department of Laboratory Medicine & Pathobiology, 233837 University of Toronto , Toronto, ON, Canada.
² Department of Clinical Biochemistry, 574811 University Health Network , Toronto, ON, Canada.

PMID: 38443327
DOI: 10.1515/cclm-2023-1192

Abstract

Objectives: The pre-analytical stability of various biochemical analytes requires careful consideration, as it can lead to the release of erroneous laboratory results. There is currently significant variability in the literature regarding the pre-analytical stability of various analytes. The aim of this study was to determine the pre-analytical stability of 65 analytes in whole blood, serum and plasma using a standardized approach.

Methods: Blood samples were collected from 30 healthy volunteers (10 volunteers per analyte) into five vacutainers; either SST, Li-heparin, K₂-EDTA, or Na-fluoride/K-oxalate. Several conditions were tested, including delayed centrifugation with storage of whole blood at room temperature (RT) for 8 h, delayed centrifugation with storage of whole blood at RT or 4 °C for 24 h, and immediate centrifugation with storage of plasma or serum at RT for 24 h. Percent deviation (% PD) from baseline was calculated for each analyte and compared to the maximum permissible instability (MPI) derived from intra- and inter-individual biological variation.

Results: The majority of the analytes evaluated remained stable across all vacutainer types, temperatures, and timepoints tested. Glucose, potassium, and aspartate aminotransferase, among others, were significantly impacted by delayed centrifugation, having been found to be unstable in whole blood specimens stored at room temperature for 8 h.

Conclusions: The data presented provides insight into the pre-analytical variables that impact the stability of routine biochemical analytes. This study may help to reduce the frequency of erroneous laboratory results released due to exceeded stability and reduce unnecessary repeat phlebotomy for analytes that remain stable despite delayed processing.

Keywords: delayed centrifugation; pre-analytical stability; refrigerated stability; room temperature serum and plasma stability; whole blood stability.