A Comparison of Results for Serum Versus Heparinized Plasma for 30 Common Analytes

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Abstract
Twenty paired serum and heparinized plasma samples were assayed for 30 common analytes in order to determine whether medically significant differences exist at high and low decision levels. Linear-regression analysis was used to determine total systematic error and to predict analyte concentrations in plasma at decision levels. The predicted value was compared with criteria for medically allowable error in order to determine the validity of substituting heparinized plasma for serum. There were statistically significant and predictable differences between heparinized plasma and serum for assays of ammonia, ionized calcium, potassium, and amylase. There was marked bias and proportional error for alanine aminotransferase, γglutamyltransferase, lactate dehydrogenase, and aspartate aminotransferase. Transferase interference was method-dependent, and findings were not consistent with the recommendation provided in the manufacturer's method description. Serious analytical errors are likely if heparinized plasma is substituted for serum without study in the user's own laboratory.

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