Procedure for ALT examination

Learn operation of Erba XL-640 and Erbachem.
Select equipment
- Use Erba XL-640 as preferred equipment.
- If Erba XL-640 is malfunctioning and can not be repaired within period acceptable to clinicians, use Erbachem and follow procedure for responding to Erba XL-640 failure
Read following documents

references	alt_kit_lit.pdf}}

comparison_of_alt_with_single_reagent_and_double_reagent

	ALT kit literature of meril
	ALT kit literature of spinreact
	part_1_stabilized_liquid_enzyme_and_coenzyme_compositions.pdf
	part_2_stabilized_liquid_enzyme_and_coenzyme_compositions..pdf
	stabilised_liquide_coenzymes_composition_and_determination.pdf
	stabilization_of_reagent_containing_nadh_andnadph.pdf
	ifcc_primary_reference_procedures_for_the_measurement_of_catalytic_activity_concentrations_of_enzymes_at_37_c.pdf
	ep0463755a1.pdf
	s_tandardization_i_n_c_linical_e_nzymology_.pdf
	d_1-s2.0-s2213020914000068-main.pdf
	altr.pdf
	alt_biopro_e_met_dxc800.pdf
	1133.full.pdf
	58.full.pdf
	153.full.pdf
	003_alt_reference_ifcc_37_temp.pdf
	ep0072581b1_stabilized_nadh_and_ldh.pdf				Note: When a new lot is opened, verify kit literature with the uploaded version.
	Upload newer version when required and make necessary changes in procedure and process

environmental and safety controls

MSDS of Transasia Kits

Document and revise common laboratory informations related to the examinations.
Depending on the selected equipment follow appropriate procedure described below.

Preparation and use of ALT reagent 001_alt_reagent..ods

Erba XL-640

Note: Following instruction is useful only if operator is familiar with Erbachem

Parameter	Value
Sample volume(ul)	50
Reagent volume(ul)	500 (R1+R2 mixed in proportion of 24 ml+6 ml)
Filter	340 nm
Aspitation Volume(ul)	300
Type of reaction	Rate A
Decimal place	0 (but 4 during calibration)
Delay	60 seconds
Read	120 seconds

Calibration, Result calculation, Quality control and sample examination in Erbachem

Internal Quality Control
EQA

testing material	Replicates
Prepare for calibration as below when lot changes or there is relevent NC. Refer Calibrator and QC
Water blank	2
Normal Range Calibrator	4
Abnormal range Calibrator	4
Normal range QC sera	4
Abnormal Range QC sera	4

Run all testing material as sample (as described below at Sample Examination)
Evaluate calibration and QC absorbances in spreadsheet. Compare with past results.
If results are acceptable, enter the factor in the erbachem and set decimal place to zero.

Sample Examination

Print examination wise worklist for ALT
Mix R1 and R2 as described in literature in sufficient quantity.
Generally 24ml R1 +6 ml R2 is mixed by adding R2 to R1.
Fill 500 ul cups with mixed reagent in required numbers.
Select “Run test” → GPT in Erbachem menu.
When instrument asks “Aspirate water”, aspirate water.
Add 50 microliter sample to a cup, mix and aspirate.
If result comes more than 5000u/L then dilute the sample to 1:1 and rerun the sample.
Wait and enter reading in worklist sheet.
Enter Calibration in LIS
Enter QC results manually in LIS
Enter sample results manually in LIS. Store the result sheet in a file for at least 2 days for use in event of LIS failures and rechecking results for NCs.
instructions for determining quantitative results when a result is not within the measurement interval: Dilution of sample with DI water is done in same way as done by Erba XL-640 automatically.