Search for a command to run...
Abstract Background Advances in laboratory medicine, including automation and reduced sample volumes, mean that the majority of all collected blood is now discarded as medical waste. Also, the Covid-19 pandemic has increased awareness of person-centric diagnostics, home testing, and decentralized solutions. Dried blood spots (DBS) have been the gold standard in newborn screening for over 50 years. However, wider clinical use of conventional DBS solutions is limited due to their non-volumetric nature. Recent developments in volumetric dried blood sampling solutions enable precise quantitation for applications like clinical chemistry and therapeutic drug monitoring. This study aims to compare a manual process with an automated workflow for quantitative dried blood spot microsampling devices, using Capitainer®B and a Tecan Fluent liquid handler robot, and to evaluate processing time, hands-on time, and staff resource requirements in the laboratory. Methods The Capitainer cards use paper, polymer microfluidics, and water-soluble membranes to meter a fixed blood volume. Blood is applied to the inlet, filling a metering channel and transferring to pre-cut 6mm sample discs. For the manual process designated tweezers were used to detach the samples which were placed directly into cobas compatible single tubes, the dried blood was manually reconstituted with PBS and Roche Tinaquant haemolysing reagent before analysed on a cobas Pro Analyzer (Roche) and tested for HbA1c. In the automated workflow an automated card handling solution that processes stacks of cards, transferring sample discs into 96-well plates with gripper arms and takes photos for quality control was evaluated. Blood reconstitution was performed using a Tecan Fluent robot before analysed. Results Hands-on time for handling 96 samples in the manual process was 85 minutes with a total process time of 145 min. In the automated workflow hands-on time was 39 minutes (total process time 150 minutes. The process time includes manual sample ID (10 minutes) and loading samples onto the cobas instrument with 5 minutes per batch. HbA1c analysis on cobas Pro showed high correlation (r > 0.99) between liquid samples and Capitainer samples for both processes. All results met accuracy goals, with individual results within ±3.0 mmol/mol at HbA1c <35.3 mmol/mol and ±8.5% at HbA1c =35.3 mmol/mol. Conclusion This study successfully developed an automated workflow for quantitative dried blood spot microsampling using Capitainer®B cards and a Tecan Fluent liquid handler robot. No difference in analytical result could be observed between the different workflows and it can be concluded that both solutions are suitable and equal in terms of sample quality. Although the total processing time was slightly longer for the automated workflow, this solution provided a walkaway time of 39 minutes, significantly improving laboratory workflow by saving staff 46 minutes per 96 samples compared to manual processing.