The Artery is your community for finding solutions to your day-to-day clinical chemistry questions. Last month, several answers were found to questions ranging from "Will FDA or CDC be releasing guidance on how lab professionals can assess immune status in people who receive the COVID-19 vaccine?" to “eGFR Calculations and DEI?”. Read on for our editor’s picks of the best discussions on the Artery in December.
Assessing Effectiveness of COVID-19 Vaccinations
Initiated by @Jack Maggiore, PhD, MT(ASCP), DABCC, FADLM
Will FDA or CDC be releasing guidance on how lab professionals can assess immune status in people who receive the COVID-19 vaccine? Respondents don’t know for sure, but one points out that we don’t routinely measure the effectiveness of other immunizations by searching for antibodies. This is because T cell immunity to viral infections is equally important and can persist for years even after antibodies fall below detectable levels. However, there are currently no routine methods to assess T cell immunity in the typical clinical laboratory.
Radioactive Specimens
Initiated by @David Alter, MD DABCC
How do other labs handle radioactive specimens, i.e. blood or urine from patients undergoing radionuclide therapy such as I-131? According to the studies that respondents have posted, the cumulative exposure from these samples is likely below the annual radiation dose limit, but labs should still take steps to protect staff. For example, labs should implement protocols for tracking the receipt, processing, and disposal of specimens from patients who have received large doses of radiopharmaceuticals.
eGFR Calculations and DEI
Initiated by @James Devitt, MD
At the request of their network diversity, equity, and inclusion (DEI) committee and several physician specialties, one lab is looking for a new GFR calculation based on a single creatinine value that does not use race and/or gender and/or age. Suggestions include removing the race-based modifier but keeping gender and age, or using other formulas such as MDRD. Another respondent says he is eager to see the final report from the NKF-ASN Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Diseases. The task force has been working on a solution to GFR estimation that will be safe, equitable, and will not disadvantage any patient by race, sex, or age.