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Dear Mailbase,

 

Have any Roche users moved to the new generation total bilirubin assay (BILT3)? If so, are you analysing neonatal samples by this method? If you’re not using BILT3, how does your hospital process neonatal bilirubin samples for inpatients and the community?

 

We have recently evaluated BILT3 and have shown it compares well with BILT2 and as claimed, is not affected by haemolysis.  

 

We were hoping to be able to switch to using the BILT3 assay to analyse neonatal samples in the lab but the assay shows a ~13% negative bias (in samples with bilirubin >100 umol/L) compared to our current neonatal method (Pfaff bilirubinometer). As we are also hoping to replace the bilirubinometer in NICU, with bilirubin on the IL GEM blood gas analyser, which gives a ~10% positive bias compared with the bilirubinometer, this no longer seems a sensible option.  

 

Can anyone help explain the differences we have seen in the bilirubin methods? Could it be due to the subtle differences in absorbance maxima and/or solubility of the bilirubin species/isoforms that are detected to varying extents by the methods?

 

  • The bilirubinometer measures plasma bilirubin at 455 nm and corrects for OxyHb by also reading at 575 nm.

 

  • The IL GEM measures lysed whole blood at ~2000 wavelengths between 480 to 650 nm, the spectrum is then resolved to calculate total bilirubin, a plasma equivalent of total bilirubin is reported after correction for haematocrit.

 

  • In the BILT3 assay, bilirubin is coupled with a diazonium ion.

 

Many thanks for any help in advance.

 

Best wishes,

 

 

Nicola

Nicola Pullan

Clinical Scientist - Biochemistry

Pathology Sciences Laboratory

Southmead Hospital

Westbury on Trym

Bristol, BS10 5NB

 

Email:  [log in to unmask]

 

Tel:  0117 32 38514           

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