Journal
CLINICAL CHEMISTRY
Volume 51, Issue 12, Pages 2341-2347Publisher
OXFORD UNIV PRESS INC
DOI: 10.1373/clinchem.2005.052639
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Background: Single-center trials have shown that monocytic HLA-DR is a good marker for monitoring the severity of temporary immunodepression after trauma, major surgery, or sepsis. A new test for measuring monocytic HLA-DR is now available. Methods: We evaluated a new test reagent set for monocytic HLA-DR expression (BD Quantibrite (TM) HLA-DR/Monocyte reagent; Becton Dickinson) in single-laboratory and interlaboratory experiments, assessing preanalytical handling, lyse-no-wash (LNW) vs lyse-wash (LW) values, reference values, and the effect of use of different flow cytometers and different instrument settings on test variance. Results: For preanalytical handling, EDTA anticoagulation, storage on ice as soon as possible, and staining within 4 h after blood collection gave results comparable to values obtained for samples analyzed immediately after collection (mean increase of similar to 4% in monocytic HLA-DR). Comparison of LNW and LW revealed slightly higher results for LNW (similar to 18% higher for LNW compared with LW; r = 0.982). Comparison of different flow cytometers and instrument settings gave CVs <4%, demonstrating the independence of the test from these variables and suggesting that this method qualifies as a standardized test. CV values from the interlaboratory comparison ranged from 15% (blood sample unprocessed before transport) to 25% (stained and fixed before transport). Conclusions: For the BD Quantibrite HLA-DR/Monocyte test, preanalytical handling is standardized. Singlelaboratory results demonstrated the independence of this test from flow cytometer and instrument settings. Interlaboratory results showed greater variance than single-laboratory values. This interlaboratory variance was partly attributable to the influence of transport and can be reduced by optimization of transport conditions. (c) 2005 American Association for Clinical Chemistry.
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