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I suspect Cryo analysis will increasingly find itself out of UKAS scope! -----Original Message----- From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Webster Craig Sent: 07 March 2016 11:36 To: [log in to unmask] Subject: Re: Specimen collection for assay of cryoglobulin It's a wonder any of these tests ever worked before UKAS Sent from my iPhone On 7 Mar 2016, at 10:27, Jonathan Kay <[log in to unmask]<mailto:[log in to unmask]>> wrote: When I was responsible for these I used to go and take the specimens myself. It saved time in the long run. See also plasma ammonium etc. Jonathan PS: This thread is now confirming my view that future accreditation efforts would be better devoted to the steps in the investigative process with the biggest errors. De minimis non curat lex. On 7 Mar 2016, at 20:49, Tetlow Tony <[log in to unmask]<mailto:[log in to unmask]>> wrote: 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 Tony Tetlow BSc, MSc, DipCB, FRCPath Consultant Clinical Scientist Directorate of Laboratory Medicine Fountain Street Ashton-under-Lyne Lancashire OL6 9RW 0161 331 6495 <image001.jpg> From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of David Parry Sent: 03 March 2016 20:05 To: [log in to unmask]<mailto:[log in to unmask]> Subject: Cyroglobulin Evaluation 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. 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