Advancing mechanistic sepsis research using remnant patient specimens

Sepsis is the third leading cause of death among hospitalized patients in the United States and remains a major global health burden. Mechanistic sepsis research is constrained by the expense and complexity of prospective biospecimen collection. Utilizing clinical diagnostic remnant specimens offers a cost-effective and scalable alternative to increase biospecimen availability and diversity. This study evaluated the volume, integrity, hemolysis, and biomarker concentrations of remnant blood specimens compared with prospectively collected research samples. A prospective cohort study was conducted among adults meeting Sepsis-3 criteria within six hours of emergency department admission at UPMC Presbyterian Hospital (October 2022–December 2023). Remnant plasma specimens were obtained from the hospital laboratory after clinical testing and compared with matched research samples for plasma volume, number of aliquots, hemolysis, and biomarker concentrations. Among 64 enrolled participants, remnant specimens provided adequate plasma volume (median 1.10 mL heparin, 0.80 mL EDTA) but yielded fewer aliquots than research specimens. No remnant samples demonstrated hemolysis after an average of 40 h at 4 °C, indicating preserved specimen integrity suitable for downstream analyses. Angiopoietin-2 and E-selectin concentrations were not significantly different between research and remnant samples (both with p = 1.0) with strong correlation (rho 0.95 and 0.78, respectively). Remnant biospecimens maintain sufficient quality and volume for mechanistic sepsis research, supporting their feasibility as a low-cost, scalable alternative to traditional specimen collection.