Dear David

Meant to email earlier. We had a UKAS inspection last April and this was one of our non-conformities. What we had to do was purchase a Dewar flask at the princely sum of £200 (we bought two – widest we could find). We fill these with commercial fine sand (purchase by me from B&Q) which had been cooked (by me in my kitchen, at home) about 200oC in a tray for 30 minute to a constant weight as judged by kitchen scales. Fill Dewar with sand and put in 37oC incubator (microbiology blood culture incubator in sample reception) with lid off. We. Additionally, had a temperature probe kept in the sand, this has to be done.

We established the this would keep the temperature at 37oC for at least 30minutes – evidence required by UKAS so this was formally investigated. When cryoglobulin is required then they have to phone the lab. We then go down to the clinic with the container (lid on) and for extra reassurance we place this in one of insulated boxes used for specimen transport from primary care . The clinic staff  are informed that we will only wait no more than 5 mins and must be ready to take the blood. A member of staff (occasionally me) attends with container and ensures prompt return of sample. The samples are pushed into the sand, temperature checked and lid put on. Return to lab and samples put into incubator to allow to separate (about 1hr), temperature of sand checked again and our SOP states the temperature should not have dropped by more than 0.5oC (it is more stable than that.

Once we have acquired the serum then sample sent to a local Immunology lab. They reheat the sample prior to analysis – once separated then transport temperature not relevant. We used to do cryoglobulins ourselves but decided we didn’t do enough (the BMS staff we very relieved when we decide this.

The ISO non-conformity was cleared by UKAS.

Hope this helps.

Best wished

Tony

 

 

Best practice recommendation for cyroglobulin evaluation is to collect blood directly into a warmed container at 37C and transport to the laboratory at or > 37C (Ann Clin Biochem 2010; 47: 8-16). We are having trouble sourcing a container that is suitable for pre-warming and transporting collection tubes for this purpose.

I would appreciate hearing about what devices other labs use for cyroglobulin evaluation and where to get them.

Many thanks

David Parry

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