Conservation d’échantillons biologiques : nouvel arrêté 19/07/2023
Téléchargez la version pdf ici
L’arrêté du 19 juillet 2023 précise les règles de conservation d’échantillons biologiques lors de la réalisation d’examens par les laboratoires de biologie médicale. Le texte vise ainsi à garantir la capacité du laboratoire de biologie médicale à répondre aux éventuels futurs besoins cliniques du patient. Pour garantir la fiabilité du résultat lors d’une éventuelle analyse ultérieure, l’arrêté indique que les laboratoires de biologie médicale doivent conserver les échantillons biologiques nécessaires réalisés lors d’examens, conformément aux besoins cliniques, aux exigences figurant dans la nomenclature des actes de biologie médicale et aux recommandations des sociétés savantes du domaine (https://www.legifrance.gouv.fr/jorf/id/JORFTEXT000047873468).
Au cours de la grossesse, lors d’une suspicion d’infection maternelle virale ou parasitaire à risque fœtal, le recours à des prélèvements du début de grossesse est indispensable. Ces sérums sont en général disponibles dans les laboratoire d’analyse médicale puisque la table nationale de codage de biologie (nomenclature des actes de biologie médicale, NABM) précise que « les sérums ayant fait l’objet d’un examen en vue du diagnostic d’une affection virale ou parasitaire doivent être conservés congelés à -18° C au moins un an » (http://www.codage.ext.cnamts.fr/codif/nabm/telecharge/index_tele.php?p_site=AMELI/ Doc 087 qui constitue la base de la version 59 de la table nationale de biologie (TNB) décret du 05 mai 2020).
Dans le cas particulier de la femme enceinte, il peut par ailleurs exister un autre prélèvement sanguin, notamment celui ayant permis la réalisation du dosage de l’hormone chorionique gonadotrope (βHCG). Ce prélèvement en général très précoce permettra le plus souvent de statuer sur une infection maternelle en cours de grossesse. Nous recommandons donc que les laboratoires conservent également un an les sérums des femmes avec un résultat de βHCG positif selon les mêmes conditions que les sérums ayant fait l’objet d’un examen en vue du diagnostic d’une affection virale ou parasitaire (congélation à -18° C).
Enfin, en raison des variations importantes des titres d’anticorps pour un même prélèvement avec différentes techniques sérologiques, ces sérums doivent être analysés par un seul laboratoire. A cet effet, les laboratoires peuvent être amenés à se solliciter mutuellement pour le transfert des échantillons sanguins.
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