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Cross-reactivity of serum indices on Abbott Architect c8000, Roche Cobas 6000 and Beckman Coulter AU5800 analyzers: HIL interference project of the Working group for the preanalytical phase, Croatian Society of Medical Biochemistry and Laboratory Medicine

Serum indices, hemolysis (H), icteria (I), lipemia (L) are determined automatically on chemistry analyzers. HIL absorbance spectra patterns overlap which could result with HIL cross-reactivity when multiple interferences are present. We aimed to investigate interference cross-reactivity and to compare cross-reactivity of indices between three different biochemistry analyzers. Study included Abbott Architect c8000, Beckman Coulter AU5800 (BC) and Roche Cobas 6000. For each interference, 6 increasing levels of interfering substances were added to serum pool (hemolysis: 0.3-10 g/L hemoglobin (Hb) by needle aspiration, icteria: 35-675 µmol/L of dissolved bilirubin, lipemia: 0.1-1.4 g/L of Intralipid). HIL indices were measured in duplicate before and after addition of second interferent (approximate values H=5 g/L, I=400 µmol/L, L=1 g/L of Intralipid) and biases between those measurements were calculated. BC provides semiquantitative results (5 categories), while Abbott and Roche express indices as corresponding concentrations: hemoglobin (g/L) for H, bilirubin (μmol/L) for I and Intralipid (g/L) for L index. Less than 10% was considered acceptable bias for Abbott and Roche, and for BC agreement of result category. Hemolysis decreased I index on Abbott and Roche (for 20% and 14%, respectively). On BC, hemolysis increased I index. L index on Abbott was higher (for 35-180%), while on Roche and BC, L index was lower (11-32% for Roche) after adding free Hb. Adding bilirubin had no effect on H index on Abbott, while on Roche and BC, H index was higher (13-35%). Bilirubin also changed L index for more than 30% on all analyzers. I index on Abbott and Roche was lower after adding Intralipid (mean bias 75% and 28%, respectively). Lipemia interfered with H index on all three analyzers (for approximately 14%). Almost all tested interference combinations showed cross- reactivity. Serum indices could be erroneous if more than one interfering substances is present in serum sample.

cross-reactivity, hemolysis, icteria, interference, lipemia, serum indices

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