Huang Bo Quan, Xie Jun Mou, Huang Zhi Jian, Lan Lan Yin, Rong Xia
Institute of Blood Transfusion and Hematology, Guangzhou Blood Center, Guangzhou Medical University, Guangzhou, China.
The Key Medical Laboratory of Guangzhou, Guangzhou, China.
Medicine (Baltimore). 2025 Jul 25;104(30):e43463. doi: 10.1097/MD.0000000000043463.
Nucleic acid amplification testing (NAT) is a highly sensitive and specific testing technology for bloodborne infectious diseases. Since 2010, blood collection and supply institutions in China have widely adopted NAT technology for blood screening, greatly enhancing blood safety. Basing it on comparison with established quality systems in serological testing processes, we aimed to establish and continuously improve a quality monitoring system that meets the requirements of NAT procedure. Statistical analysis was conducted using the daily performance data of the Grifols Procleix Panther nucleic acid testing system in the laboratory from 2021 to 2022, including test frequency reactive rate, invalid test rate, system failures frequency, and laboratory contamination monitoring indicators. In 2021 and 2022, the annual discriminated rate on NAT yield donation were 39.11% and 39.29%, respectively. The average annual invalid test rates for the 4 units of Grifols Panther systems were 1.80%, 1.47%, 1.60%, and 1.51%, resulting in an overall invalid test rate of 1.60% (7881/493, 137). A total of 377 invalid runs occurred, with the most frequent invalid test reasons being 64 instances of insufficient internal control detection ("low internal control"), 55 instances of issues with verifying the volume of target capture reagent + samples ("VVFS"), and 49 instances of the presence of clots detected during aspiration ("CLT"). The most significant contributor to invalid test counts was pipette malfunction ("PMFR"), which accounted for 2136 invalid tests. In the laboratory contamination monitoring, a total of 792 monitoring tests were conducted over a 2-year period, during which hepatitis B virus DNA was detected once in a specimen centrifuge cup. Establishing systematic quality monitoring indicators can effectively and promptly identify potential quality risk factors, thereby ensuring the quality of blood testing.
核酸扩增检测(NAT)是一种用于检测血源性病原体感染的高灵敏度和特异性检测技术。自2010年以来,中国的采供血机构已广泛采用NAT技术进行血液筛查,极大地提高了血液安全性。基于与血清学检测过程中既定质量体系的比较,我们旨在建立并持续改进符合NAT程序要求的质量监测体系。使用2021年至2022年实验室中Grifols Procleix Panther核酸检测系统的日常性能数据进行统计分析,包括检测频率反应率、无效检测率、系统故障频率和实验室污染监测指标。2021年和2022年,NAT产量捐赠的年度鉴别率分别为39.11%和39.29%。Grifols Panther系统4个单元的年平均无效检测率分别为1.80%、1.47%、1.60%和1.51%,总体无效检测率为1.60%(7881/493,137)。共发生377次无效运行,最常见的无效检测原因是64例内部控制检测不足(“内部控制低”)、55例目标捕获试剂+样本体积验证问题(“VVFS”)和49例抽吸过程中检测到凝块(“CLT”)。导致无效检测次数最多的原因是移液器故障(“PMFR”),占2136次无效检测。在实验室污染监测中,两年期间共进行了792次监测检测,在此期间,在一个标本离心杯中检测到一次乙型肝炎病毒DNA。建立系统的质量监测指标可以有效、及时地识别潜在的质量风险因素,从而确保血液检测的质量。