ABSTRACT
The study aimed to determine the impact of implementing a patient blood management (PBM) policy during total hip arthroplasty. Firstly, the authors collected retrospective data concerning blood consumption for all patients (N = 577) having undergone total hip arthroplasty between 2009 and 2011, other than for post-traumatic indications. During this period, no coherent blood management rules were in place. Based on the results obtained, a blood transfusion strategy called Patient Blood Management (PBM) was defined and implemented in our department for this type of surgical procedure beginning 2012. The impact of PBM was then analyzed after a 6-month prospective study during 2013/2014 on a cohort of 123 patients. These prospective data demonstrate that PBM significantly improved patient care and reduced the need for allogeneic labile blood transfusions.
Subject(s)
Anemia/therapy , Arthroplasty, Replacement, Hip/methods , Blood Transfusion/methods , Patient Selection , Postoperative Complications/therapy , Adult , Aged , Aged, 80 and over , Anemia/metabolism , Anemia/prevention & control , Blood Loss, Surgical , Blood Transfusion, Autologous , Disease Management , Female , Hemoglobins/metabolism , Humans , Male , Middle Aged , Organizational Policy , Postoperative Complications/metabolism , Postoperative Complications/prevention & control , Practice Guidelines as Topic , Prospective Studies , Retrospective Studies , Transplantation, HomologousABSTRACT
Macroenzymes, complexes of serum enzymes with a plasma protein, are able to cause falsely increased total serum enzyme levels. We report the case of a patient presenting with an isolated increase of serum lactate dehydrogenase (LDH) activity due to the presence of a complex of LDH with an immunoglobulin, identified as IgG kappa. Before the macroenzyme responsible for the LDH elevation was detected, the patient underwent extensive diagnostic procedures, including splenectomy. Awareness of this phenomenon could prevent unnecessary, invasive and costly investigations.
Subject(s)
L-Lactate Dehydrogenase/blood , Multienzyme Complexes , Adult , Electrophoresis, Agar Gel , Humans , MaleABSTRACT
BACKGROUND: Sex hormone binding globulin (SHBG) is important for the transport and regulation of distribution of sex steroids. METHODS: The performance of the Architect SHBG automated immunoassay in comparison to radioimmunoassay was evaluated using 62 patient specimens. Furthermore, specimen from 100 healthy individuals were used to establish a preliminary reference interval for this automated assay. RESULTS: The assay has demonstrated overall good analytical performance and was significantly correlated with the reference method. CONCLUSIONS: The Architect SHBG assay is a good method for routine measurement of SHBG circulating levels.
Subject(s)
Immunoassay/methods , Sex Hormone-Binding Globulin/analysis , Europe , Female , Humans , Male , Reference StandardsABSTRACT
OBJECTIVES: This study evaluated the analytical characteristics of the new Abbott microparticle enzyme immunoassay (MEIA) for sirolimus. DESIGN AND METHODS: The protocol consisted of nine sections: evaluation of antibody specificity, linearity, detection limit, quantification limit, endogenous interferents, exogenous interferents, precision, proficiency testing panel, and method comparison. RESULTS: The mean analytical detection limit was 0.68 microg/L. The sirolimus concentration corresponding to a total CV of 20% was 1.5 microg/L. Linearity of response was demonstrated across the dynamic range of the assay. Total precision (CVs) at QC control levels from 5 to 22 microg/L ranged from 5.7 to 12.6%. Assay standardization was found to be in good agreement with LC/MS/MS as compared with target values for spiked sirolimus proficiency samples from an international sirolimus proficiency testing program. Good correlations (R values) of the immunoassay were observed in comparisons to LC/MS/MS. R values tended to be lower in comparisons with LC/UV methods. Across both LC-based methods and all study sites, there was approximately 25% overall positive slope bias due to cross reactivity of the MEIA antibody to metabolites of sirolimus. The assay cross-reactivity to metabolites of sirolimus parent drug ranged from 6 to 63%. Assay interferences were minimal with the exception of hematocrit, which presented a negative relationship to measured sirolimus concentration. CONCLUSIONS: The MEIA demonstrated acceptable analytical characteristics for use for routine monitoring of sirolimus immunosuppressive therapy, and is a viable alternative to HPLC-based methods for sirolimus monitoring.
Subject(s)
Immunoenzyme Techniques/methods , Immunosuppressive Agents/blood , Sirolimus/blood , Calibration , Chromatography, High Pressure Liquid , Chromatography, Liquid , Humans , Reproducibility of Results , Sensitivity and Specificity , Spectrophotometry, Ultraviolet , Tandem Mass SpectrometryABSTRACT
The Publisher regrets that this article is an accidental duplication of an article that has already been published in Clin. Biochem. 39 (2006) 378-386, doi:10.1016/j.clinbiochem.2006.01.017. The duplicate article has therefore been withdrawn. This article has been withdrawn consistent with Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). The Publisher apologizes for any inconvenience this may cause.
ABSTRACT
A new immunoassay of sirolimus based on the microparticle enzyme immunoassay (MEIA) principle has been developed with collaboration of Abbott Diagnostics. Laboratories and Axis-Shield. Our laboratory evaluated this new assay on 153 whole blood samples (EDTA) drawn from a population of renal (n = 141) and hepatic (n = 12) transplant patients. Each blood sample was analyzed simultaneously by MEIA (Y) and by a reference method (X) used routinely in our laboratory, namely, liquid chromatography tandem mass spectrometry (LC-MS/MS). The statistical analysis of Passing-Bablok produced the following results: Spearman r value = 0.95, slope = 1.15 and intercept with the Y axis = +0.2 ng/mL. The observed global overestimation of 15% compared to the reference method could be explained by the cross-reactivity of sirolimus metabolites with the antibody. A complementary analysis taking into account the transplanted organ (kidney versus hepatic) did not show any significant difference between the populations, most likely owing to the low number of hepatic transplantation samples. The analytical performance of the MEIA method showed CV < or =10% and a limit of quantification of 1.5 ng/mL, which were acceptable for routine clinical monitoring. In conclusion, the MEIA method has shown robust, stable, reproducible, features with an excellent correlation with the reference LC-MS/MS method.
