Pneumatic tube transport of blood samples affects global hemostasis and platelet function assays

Introduction: Pneumatic tube systems (PTS) are frequently used for rapid and cost-effective transportation of blood samples to the clinical laboratory. The impact of PTS transport on platelet function measured by the Multiplate system and global hemostasis measured by the TEG 5000 was evaluated. Methods: Paired samples from healthy adult individuals were obtained at two study sites: Rigshospitalet (RH) and Nordsjællands Hospital (NOH). One sample was transported by PTS and one manually (non-PTS). Platelet function was assessed by platelet aggregation (Multiplate) and global hemostasis was assessed by a variety of thrombelastography (TEG) assays. Multiplate (n = 39) and TEG (n = 32) analysis was performed at site RH, and Multiplate (n = 28) analysis was performed at site NOH. Results: A significant higher agonist-induced platelet aggregation was found for PTS samples compared to manual transport at site NOH (P <.02, all agonists). No significant difference was found at site RH (P >.05, all agonists). For Kaolin TEG, samples transported by PTS showed a significant lower R-time and higher Angle (P <.001). No significant differences in MA and LY30 was found (P >.05). ACT of RapidTEG was significantly reduced (P =.001) and MA of Functional Fibrinogen TEG was significantly increased (P <.001) after PTS transport. No significant impact of PTS was observed for TEG assays with heparinase (P >.05). Conclusions: Depending on the type of PTS, transportation by PTS affected platelet aggregation measured by Multiplate. Furthermore, PTS alters TEG parameters possibly reflecting coagulation factors. Clinical laboratories should evaluate the effect of the local PTS on Multiplate and TEG results.