Collection containers, swabs and requisitions are available from Hospital Stores.

1. For additional information on specific procedures, please refer to the individual listing within the Pathology Handbook. Further questions may be referred to the Molecular Pathology Laboratory (4-9568) or the Microbiology resident pager, #4903.

2. Use universal precautions for handling all specimens.

3. All specimens must be appropriately labeled with the requisition number sticker from the corresponding requisition if available or with the patient name and patient identifier.

4. Specimens may be hand delivered to the laboratory. Specimens may be transported via the runners from Specimen Control if the specimens are not indicated as deliver immediately. Specimens may be transported through the pneumatic tube system if approved by Pneumatic Tube Administration. This includes vacutainer tubes and swabs.

5. Specimens should be in tightly sealed, leakproof containers. Specimens which are externally contaminated will be rejected


Anatomic Pathology and Oncology specimens:

1. Whole blood collected in EDTA (lavender tube) or ACD (yellow tube). Transport blood to the laboratory at room temperature within 24 hours.

Minimum volume for processing is 3 ml of whole blood for adults and 1 ml for pediatric patients. Blood may be stored up to 24 hours at room temperature. Long term storage should be at 2-8°C.

2. Bone marrow collected in EDTA (lavender tube) or ACD (yellow tube). Transport bone marrow to the laboratory at room temperature within 24 hours.

Bone marrow may be held at room temperature without processing for up to 24 hours.

3. Extracted DNA samples may be transported at room temperature. They are best transported as an ethanol precipitate.

4. Formalin fixed paraffin embedded tissue. Specimens fixed in B5 are not acceptable because heavy metal interferes with PCR reaction. Submit a stained slide with any tissue block.

minimum = 2, 5mm sections

5. Tissue: 3 x 3 x 3 mm piece is optimal. Specimen should be frozen at < -20°C as soon as possible after collection and transported to the laboratory on dry ice.


Genetic specimens:

1. Whole blood collected in EDTA (lavender tube) or ACD (yellow tube). Transport blood to the laboratory at room temperature within 24 hours.

Minimum volume for processing is 3 ml of whole blood for adults and 1 ml for pediatric patients. Blood may be stored up to 24 hours at room temperature. Long term storage should be at 2-8°C.

2. Formalin fixed paraffin embedded tissue. Specimens fixed in B5 are not acceptable because heavy metal interferes with PCR reaction.

minimum = 2, 5mm sections

3. Extracted DNA samples may be transported at room temperature. They are best transported as an ethanol precipitate.


Infectious Disease specimens:

Chlamydia Trachomatis Polymerase Chain Reaction (PCR) Assay:

Viral and Chlamydia Transport kit Hospital Stores Number MH08379

1. Female endocervical swabs and Male urethral swabs

a. Avoid urination for 1 hour prior to urethral collection. For endocervical swabs remove the mucous with a large swab.

b. Insert clean swab into endocervix canal until tip is no longer visible or 2-4 cm into the urethra.

c. Rotate 3-5 seconds. Withdraw.

d. Vigorously agitate swab in medium for 15 seconds.

e. Swab specimens may be transported to the lab at room temperature (18-25°C) provided that the total time at room temperature does not exceed 1 hour. Refrigerate specimens or transport on ice if receipt in lab will be greater then 1 hour. Process swabs within 7 days of being received in the laboratory. If swabs cannot be processed within 7 days, store at -20°C for up to 30 days.

2. Male and Female first catch urine:

a. Collect 10-50 ml in a clean plastic container - patients must not have urinated during the previous 2 hours.

b. Transport urine specimens at room temperature. Urine specimens are stable for 24 hours at room temperature. Urine specimens stored at room temperature for more then 24 hours may result in specimen degradation.

Upon receipt the specimen should be stored at 2-8°C. Process urine specimens within 7 days of collection. Urine specimens that can not be processed within 7 days can be stored at -2°C for up to 2 months.

3. Specimens that require shipment from off-site test centers must be stored at 2-8°C until shipment. Specimens should be shipped with guaranteed arrival of 24 hours.

Hepatitis C (HCV) PCR Assays (Qualitative, Quantitative and Genotyping):

1. Whole blood collected in plasma preparation tube (ppt, EDTA, white top).

2. Serum or plasma collected in ACD or EDTA are also acceptable. Specimens anticoagulated with heparin are unsuitable for this test.

3. Transport the specimen at room temperature. Store blood at 2-25°C no longer than 6 hours.

4. Within 6 hours of blood draw, blood collection tubes must be centrifuged at 800 - 1600 x g for 20 minutes at room temperature. Store ppt tube at 2-8° C for up to 72 hours. Plasma or serum from red top, ACD or EDTA tubes must be separated into sterile Rnase free tubes immediately after centrifugation.

HIV Viral Load Assay:

1. Whole blood collected in EDTA (Lavender top).

2. Store whole blood at 2-25°C for no longer than 6 hours.

3. Transport whole blood at room temperature. Plasma may be transported at 2-8°C or frozen.

5. Within 6 hours of blood draw, blood collection tubes must be centrifuged at 800-1600 x g for 20 minutes at room temperature. Transfer the plasma from ACD or EDTA (lavender) tube to sterile Rnase-free tubes and store at room temperature for up to 1 day or 2-8°C for up to five days. Store centrifuged ppt tube at 2-8°C for up to 72 hours. For longer storage, store at -20 to -80°C. Plasma specimens may be frozen and thawed up to three times.


REFERENCES:

Package Inserts, Roche Molecular System, INC.

Current Protocols in Molecular Biology. F. Ausbel, R. Kingston, 1987

Puregene ® DNA Isolation Kit Procedure. Gentra Systems. 1997.

Qiagen EZ1 DNA Handbook, 2004.