What is the shelf life and journey of a blood sample?

The blood sample journey from collection to lab analysis is critical to ensuring accurate diagnostic results. Here's a comprehensive look at this process and the shelf life of various blood samples.

1. Shelf Life of Blood

Whole blood samples of liquid or “wet” blood have a short shelf life. For example, six weeks is considered the maximum "shelf life" of a blood donation intended for transfusion. After just three weeks, blood is less effective at delivering oxygen-rich cells through the body, and also is less able to flow through the body's smallest capillaries.

2. Lab Testing and Blood Collection

“For specimen integrity and accurate test results, blood samples must be transported and stored in specific ways,” says James Rudge, PhD, Microsampling Technical Director, Trajan. “The way the blood is initially collected and how it's transported and stored affect its long-term viability.”

For example, a wet blood sample that has been collected via a traditional phlebotomy blood draw into vials or tubes cannot remain at room temperature longer than eight hours.

3. Maintaining Wet Blood Sample Viability

If a wet blood sample is kept at room temperature, in most cases it should be in the laboratory for analysis within eight hours of the blood collection event. If sample analysis cannot be completed within that 8-hour timeframe, the sample is typically placed in cold storage at +2°C to +8°C for no longer than seven days.

If assays on a wet blood sample are not completed within seven days, or if the sample is to be stored for longer than seven days, it should be frozen at -15°C to -20°C.

4. Dried Blood Samples: A Preferable Alternative

"On the whole, dried blood remains stable at ambient temperatures much longer than wet blood," adds Dr. Rudge. "Dried blood samples usually stay viable for a few weeks at room temperature. Further, many dried blood samples don't require cold shipping or cold storage for medium- and sometimes long-term viability, which is why many research scientists and healthcare professionals have switched to using dried blood samples for their lab testing."

Whether a blood sample is considered “wet” or “dry,” what happens to it once it has been collected?

5. Blood Sample Journey Post Collection

Once a blood sample is delivered or shipped to the lab, trained technicians use various methods to test it, based on which types of analysis is needed. If multiple tests are needed, the lab technicians will use more than one sample of blood.

This is why a phlebotomist performing a venipuncture blood draw collects multiple tubes of blood for a single blood test. The phlebotomist knows that if a blood sample is too small, a lab test cannot be repeated to confirm the first result.

6. Sample Volume

A traditional approach to "wet" blood draws is to collect between 2 and 2.5 times the volume that a blood test requires — enough to run two tests of each type. However, most standard blood draws take too much blood, and even after running two tests from a single sample, much of the blood is thrown away. The same "two times the volume" rule applies to dried blood testing, though a much smaller volume of blood is needed for each test.

For example, if you are using a portable device to collect small drops of blood from your fingertip for dried blood testing, you will need to collect the blood drops onto 2-4 device tips or 2-4 spots on filter cards. 

7. Proper Labeling

When blood is being collected from an individual, the tubes, devices or filter papers are labeled. This ensures proper matching of blood samples and results to all documents for that individual. In some blood draw centers or labs, the label is pre-printed with the individual's name and their patient identification number.

Alternately, the tubes or devices may be labeled with a unique barcode that includes an individual’s pertinent information or a unique string of numbers. If you are self-collecting blood samples at home using finger-stick microsampling for dried blood testing, make sure the device or filter paper is labeled with a unique barcode or patient label. It is essential that the samples are properly labeled before they leave your side.

At the lab, the label on your blood samples will be logged into a tracking system. This information ensures your samples are tested appropriately and the results are identified with you throughout processing. After testing, the lab will send an electronic form listing your results and other information to the appropriate person, such as your physician or the clinical trial manager.

8. Blood Processing and Analysis

For whole blood testing, a blood sample can be analyzed directly with perhaps just a simple dilution. However, depending on which tests are needed, your blood sample is often further processed before it is analyzed.

Many blood tests are performed on either plasma or serum, which require a separation step to remove the cellular fraction. Some blood tests, such as neonatal screening for inborn errors of metabolism, are performed using dried blood samples, which also requires sample processing before analysis. 

• Plasma, which is the liquid portion of blood, is collected into a tube with anticoagulant. At the lab, plasma is separated from the cellular portion of the wet blood sample by rapidly spinning it in a centrifuge. This centrifugation process pellets the cellular fraction, leaving the straw-colored plasma at the top of the tube.
  
  
• Serum, which is essentially the liquid left from the clotting process, is obtained by centrifugation where the clotted cellular fragments pellet at the bottom of the tube, leaving the clear liquid at the top of the tube — ready for analysis. 
  
  
• Dried blood is a sample of capillary blood collected from a fingertip or heel-stick that dries on a blood microsampling device or dried blood spot (DBS) card. The tip of the microsampling device or spot on the DBS card that has absorbed the blood is typically added to a tube of liquid for extraction and analysis in the lab.

The extractant used will vary according to the type of test. While capillary blood is not identical to venous blood or arterial blood, dried capillary samples deliver results that are equivalent to venous blood samples. They furnish scientific and clinical data that provide both researchers and healthcare providers with critical information.

9. Lab Results and Communication

With technological advancements, the turnaround time for blood test results has reduced significantly. In most instances, results are available within days. Once the healthcare professional receives the results, they can then convey the findings to their patient, thus concluding the journey of the blood sample.

In essence, the journey of a blood sample, from collection to the lab and generation of data, must ensure the integrity of the sample and the accuracy of the results. Proper handling, storage, and processing of blood samples are fundamental for reliable and accurate outcomes.

Sources:

https://labtestsonline.org/articles/laboratory-tour-blood%20sample