B-040 Direct Aspiration of Cryogenic Matrix Tubes on the Siemens Atellica System With Epic-Beaker Integration of External Barcode IDs for Analysis Small Volume Biobanked Specimens
Authors: Cotten S , Engman D , Thomas P 
Published: October 2024

Abstract

Background
Most core chemistry and immunochemistry clinical analyzers are designed for direct sampling of primary blood tubes with volumes ranging from 3.5-10 mL. This limits analysis of low volume pediatric specimens and biobanked aliquoted samples from clinical trials without manual technologist intervention. This work outlines a microsampling and data transmission scheme for analysis of 500 uL aliquots of biobanked serum collected for the Nutrition for Precision Health study powered by the NIH All of Us Research Program without relabeling secondary aliquot tubes after receipt.

Methods
Commercial plastic clip bearings sourced from IGUS (LCM-08-02) were used to stabilize the matrix tube in a standard 5 mL Sarstedt aliquot tube. 96-well format Matrix Tubes (ThermoFisher 3719-11) with pre-printed 10-digit side barcodes were programmed in the Atellica software as a custom false bottom tube with specifications height 75 mm, diameter 12 mm, bottom offset 41 mm and were loaded using a dedicated false bottom tray. Manifest files (.csv) containing the sample ID, clinical trials participant ID, collection date/time, age and sex were ingested into Epic via an Incoming Orders HL7 interface. Non-human patient records were generated using the participant ID as an external patient ID and patient name and calculating the Date of Birth based on the age in years given in the manifest file. Test orders were created based on assigned testing for the sample ID in the manifest. The sample ID corresponding the preprinted Matrix Tube barcode ID was inserted into the Epic container identifier field.

Results
Test orders were automatically transmitted to the Atellica Data Manger (ADM) allowing specimens to be run on the Atellica System (CH and IM modules) and results transmitted to Epic utilizing the established Data Innovations (DI) interface and processes used for patient samples without the need for Epic generated labels. Successful scanning and recognition of Matrix Tube barcodes was 100%. Complete aspiration of a Comprehensive Metabolic Panel, Lipid Panel, Iron, TIBC, hsCRP, insulin, and H, I, L indices occurred for 50% of samples tested without intervention. Approximately 250 uL of the 500 uL aliquot remained after aspiration of all tests (247.7 uL total volume) from the Matrix Tube. No probe crashes were observed despite the narrower 8 mm diameter of the Matrix Tubes versus the standard 12- or 13-mm diameter of primary blood collection tubes.

Conclusions
This Epic-DI-ADM data workflow and microsampling adaptation for Matrix Tube aspiration allows greater container type flexibility for the receipt and analysis of external samples delivered in non-primary blood tubes for clinical laboratories. Future work involving adjustment of the false bottom tube offset depth may reduce unusable sample volume allowing for a higher percentage of complete aspiration without intervention. This work is significant because it suggests existing clinical analyzers are easily adaptable to microsampling smaller volume tubes without significant effort.