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https://doi.org/10.11613/BM.2018.010903

Upfront dilution of ferritin samples to reduce hook effect, improve turnaround time and reduce costs

Shu Juan Wu ; Central Laboratory, Weill Cornell Medical College, New York Presbyterian Hospital, New York, USA
Joshua A. Hayden orcid id orcid.org/0000-0003-0435-9275 ; Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, USA


Puni tekst: engleski pdf 883 Kb

str. 121-124

preuzimanja: 442

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Sažetak

Introduction: Sandwich immunoassays offer advantages in the clinical laboratory but can yield erroneously low results due to hook (prozone)
effect, especially with analytes whose concentrations span several orders of magnitude such as ferritin. This study investigated a new approach to
reduce the likelihood of hook effect in ferritin immunoassays by performing upfront, five-fold dilutions of all samples for ferritin analysis. The impact
of this change on turnaround time and costs were also investigated.
Materials and methods: Ferritin concentrations were analysed in routine clinical practice with and without upfront dilutions on Siemens Centaur®
XP (Siemens Healthineers, Erlang, Germany) immunoanalysers. In addition, one month of baseline data (1026 results) were collected prior to implementing
upfront dilutions and one month of data (1033 results) were collected after implementation.
Results: Without upfront dilutions, hook effect was observed in samples with ferritin concentrations as low as 86,028 μg/L. With upfront dilutions,
samples with ferritin concentrations as high as 126,050 μg/L yielded values greater than the measurement interval and would have been diluted
until an accurate value was obtained. The implementation of upfront dilution of ferritin samples led to a decrease in turnaround time from a median
of 2 hours and 3 minutes to 1 hour and 18 minutes (P = 0.002).
Conclusions: Implementation of upfront dilutions of all ferritin samples reduced the possibility of hook effect, improved turnaround time and saved
the cost of performing additional dilutions.

Ključne riječi

immunoassay; prozone effect; ferritin; turnaround time

Hrčak ID:

189598

URI

https://hrcak.srce.hr/189598

Datum izdavanja:

15.2.2018.

Posjeta: 1.140 *