The transport of biological materials: A proposal from the Italian Federation of the societies of Laboratory Medicine (FISMeLab)

In recent years the transport of biological samples has become a strategic theme. Their movement from a rare event has become a frequent practice due to the tendency of public laboratories to move towards consistent centralizations and of private laboratories to join or to entrust to others, bigger or more equipped (“hub and spoke” model), to process a substantial part of the analytical repertoire. Moreover, the presence of the sampling centers becomes more numerous and more widespread in the territory to improve the service to the citizens. The time and the way of remote transport of biological samples is a source of potential corruption of the matrix that generates preanalytical errors of various kinds and severity. The lack of unequivocal indications of behavior in Italy has prompted the Italian Federation of Laboratory Medicine Societies (FISMeLab) to set up a working group made up of representatives of the various participating Scientific Societies, with the aim of drafting a manual of practical behavior on the transport requirements of biological materials. The leading idea is that the recommendations include the individual measurands in the various areas of the laboratory, also covering the steps immediately before and after their shipment, without however conflicting with the quality systems of the individual laboratories. In most cases the user can consult a table where he will find the name of the measurand and the recommendation of how to treat it in the most reliable way from the end of the sampling at the beginning of the analysis in order not to compromise the accuracy of the measurement, considering the temperature of transport or any need to separate the plasma/serum from the corpuscular part, the possible need to freeze the sample and at what distance of time from the sample. The recommendations described take into account the best evidence of the available literature, which are rather scattered and sometimes ambiguous. These recommendations are organized into many “special” parts, one for each area of the laboratory: biochemistry, hematology, coagulation, transfusion medicine, pathology, microbiology, immunophenotyping in flow cytometry, cytogenetics and molecular genetics. Transportation time was considered a critical issue. It is recommended to divide it into two segments: less than three hours and more than three hours after the end of the withdrawal period. It is recommended that the withdrawal time be contained within two hours and that the waiting time of the transport be as short as possible.