Frequently Asked Sample Collection and Shipping Questions
Click on a question below to be taken directly to the answer.
Q: Does it matter if I use PPT or EDTA tubes?
A: Either PPT or EDTA tubes may be used for testing at Monogram. When using EDTA tubes, however, the plasma must be aliquoted into labeled plastic tubes directly after centrifugation and before freezing.
Q: What if I can’t spin the samples right away?
A: Samples should be centrifuged immediately after drawing for best results, however, a delay of up to half-an-hour should not significantly affect the results, provided the samples remain at ambient temperatures (20-25°C). Do not freeze and thaw the sample while waiting to centrifuge.
Q: Why do the samples need to be frozen?
A: For successful RT/PCR amplification in Monogram’s assays, the viral genomic RNA molecule must be intact. Viral nucleic acids begin to degrade rapidly at ambient or higher temperatures. Samples are frozen as soon as possible to ensure that the integrity of the viral RNA is not compromised.
Q: We don’t have a centrifuge or a freezer in our office, what should we do?
A: Samples must be handled in the proper manner to assure quality results. Please contact us at 800-777-0177 or firstname.lastname@example.org to work out the best solution for your facility.
Q: How do I make sure my freezer and centrifuge are working properly?
A: The temperature inside the freezer should be maintained at –20°C, +/- 2°C and checked regularly. A thermometer with the appropriate range should be kept inside an ethylene glycol-filled container in the freezer. Freezers should be monitored daily by recording the temperature on a chart, so that you can see easily if the freezer temperature starts to drift. Centrifuges should be inspected and calibrated according to the state rules governing your lab, usually at least once a year. If your centrifuge heats up significantly during the course of the day, doesn’t close properly, or starts to get much louder, it is advisable to have it looked at as soon as possible.
Q: How does improper sample handling affect samples?
A: If a patient has a low viral load to begin with, the natural degradation of the viral RNA that can occur if samples are improperly handled might make it difficult to amplify the sample sufficiently to get an accurate result. If the patient has a high viral load, the impact of leaving a sample out a few extra minutes before spinning or freezing might not be as noticeable, but you still run the risk that you might not amplify all of the significant quasi-species (viral variants) that have developed within the patient.
Q: Does the patient need a viral load test before getting a resistance test?
A: For best results, viral loads should be collected either at the same time, or within the two weeks prior to collection for testing at Monogram.
Q: Why is viral load important for resistance testing?
A: Viral load can have an effect on the ease with which a good representation of the patient’s virus population can be amplified. Amplification is one of the first steps in our assay and getting a representative amplified population is vital to good test results. Lower viral load samples (<1000 for Trofile copies) are less likely to be able to be amplified. Or, if we are able to amplify the viral RNA, the amplified product may not be representative of the true viral population of the patient. See the enclosed discussion on viral loads in Section 2 for more on this topic.
Q: Why are Monogram’s processes different from some other labs we work with?
A: A resistance test is a complex assay that requires excellent sample integrity to achieve the best results. We have designed our sample collection and handling protocols to ensure that we have the best opportunity to get accurate results for your patients. In some cases, the procedures for handling our samples may be more stringent than other common blood tests because our assay is dependent on being able to extract intact viral RNA from the frozen plasma sample that you send to us. We then go through a process to amplify this viral RNA and the better condition that the original RNA arrives, the better our likelihood of getting good results. By following our sample collection requirements, you will help to ensure this.
Q: How do I get my samples picked up?
A: Call 800-777-0177. Monogram will dispatch a courier to your office. If you call before 1pm (your local time), the courier will arrive the same day for overnight delivery to Monogram. After 1pm, the pickup will be made the following day, but the sample should be maintained in the freezer during this time.
Q: Does Monogram have its own couriers?
A: Monogram provides contracted courier services for most geographical locations in the United States. These couriers are trained according to Monogram protocols that include IATA/DOT regulatory procedures, general handling protocol, and shipping procedures. Our couriers are outfitted with Monogram shipping kits for the transport of infectious and diagnostic specimens.
Q: Should I send samples with the courier if they are not fully frozen?
A: As stated above, our assay depends on proper sample collection and handling. Part of this includes ensuring that the sample is fully frozen BEFORE putting it on dry ice with the courier. It is possible that the flash freezing of putting a partially frozen or unfrozen sample directly on dry ice, could impact the quality of the sample.
Q: What is the contact info for shipping to Monogram?
A: Logistics Manager
Monogram Biosciences, Inc.
345 Oyster Point Boulevard
South San Francisco, CA 94080