Spain's first automated clinical and healthcare analyser with mass spectrometry installed at Bellvitge Hospital


It is the only fully automated device of its kind in Spain that will be used to analyse patient samples to facilitate clinical decision-making, thus putting technology of excellence at the service of the entire population. It will have a major impact on the rejection prevention in organ transplantations by offering an innovative 24/7 immunosuppressant analysis service.

The device is key to the hospital's commitment to personalised precision medicine.

The South Metropolitan Territorial Clinical Laboratory (LCTMS), located at the Bellvitge University Hospital (HUB), carries on with its technological renovation. Now, it has a fully automated analyser for in vitro diagnostics based on high performance liquid chromatography coupled to tandem mass spectrometry (UHPLC-MS/MS).

In addition to providing service to Bellvitge, one of the hospitals where most transplants are performed in Catalonia, the new automated UHPLC-MS/MS, named Cascadion SM, will be used for the determinations required by specialists at the Catalan Institute of Oncology (ICO), especially in bone marrow transplants for oncology and haematology patients. At the same time, it will provide services to the ICS Camp de Tarragona and Terres de l'Ebre laboratories and occasionally to other hospitals -not only from the ICS- that request this type of tests.

One of the determinations already being made thanks to the new analyser is that of immunosuppressants, an essential lifelong medication for transplant recipients. In patients at risk of organ rejection or toxicity for various reasons, the device will allow medical specialists to quickly and accurately obtain information on the medication effectiveness for the patient and, if necessary, to modify it and achieve implant survival.

This device is the first of its kind in Spain to be used for the determination of immunosuppressants, having a major impact on the diagnostic services of the HUB. It reinforces the hospital's commitment to personalised precision medicine with the best diagnostic tools.

In the coming months, the LCTMS will also renew its non-automated UHPLC and UHPLC-MS/MS instrumentation where determinations for antiretrovirals, antipsychotics, antibiotics, antiepileptics, B vitamins, vitamins A and E, mycophenolate and biogenic amines are performed.

The implementation of these reference technologies will make it possible in the future to standardise and harmonise outcomes across the public health system. In other words, it will be possible to establish equivalence of results throughout the territory to support clinical decisions.

Better quality of results and greater safety for the patient and the professional

The new Cascadion device enables 24/7 operation, which will ensure continuity of service during weekends and holidays. It also allows full automation, from sample loading to results delivery.

The fact that it is fully automatic "facilitates the training of technicians, simplifies the process and the laboratory routine, obtaining results more quickly and with a resulting reduction in the probability of error in the manual sample preparation, proportional to an improvement in the safety of patients and professionals. Moreover, not only is the quality of the results not lost, but quite the opposite their accuracy is improved", according to Dr Pedro Alía, head of the Special Biochemistry section at the HUB.

"Chromatography and mass spectrometry are leading technologies that allow us to improve the reliability of the results given their intrinsic properties to simultaneously separate, isolate, identify and quantify different components of a sample," states Dr Raül Rigo-Bonnin, clinical biochemist and specialist physician in the Special Biochemistry Area of the HUB. "Using this technology will enable us to incorporate new pharmacological magnitudes in the LCTMS catalogue of services that are currently outsourced, and to give continuity to Research, Development and Innovation (R+D+i)", he adds.

"This is a bet on technology with a major impact and benefits for the patients of a high complexity hospital such as the HUB. Thanks to the support of the hospital management and the ICS South Metropolitan Territorial Management, our clinical laboratory will be able to offer accurate, high-quality and comprehensive results, and with the speed required by our specialised medical team of excellence to support their clinical decisions," according to Dr Núria Llecha, clinical director of the LCTMS.

A new laboratory prepared for precision personalised medicine

The new LCTMS performs more than 12 million determinations annually to serve the University Hospital of Bellvitge, the Viladecans Hospital, emergency and continuous care devices, and 47 primary care and ASIR teams of the Southern Metropolitan Area of the ICS, all of them with up to 83 extraction and sample collection centres.

The service performs clinical analyses and clinical biochemistry, haematology, immunology, genetics, and microbiology and parasitology determinations for the care centres. In fact, 70% of the medical team's clinical decisions are based on the results of the tests carried out in the laboratory.

Dr Llecha stresses that the new LCTMS "is prepared to respond to both the most specialised needs of a high-level hospital and the high volume of demand in the territory." This demand, she states, "is growing due to the progressive ageing of the population and the constant advances in fields such as genetics, which mean that an increasing number of analyses are necessary".

Since the end of 2021, the LCTMS will also have the Core Laboratory for Molecular Analysis, a device that offers molecular diagnosis, genetic counselling and clinical monitoring to patients and families with suspected hereditary diseases. This service is promoting genomic medicine or personalised precision medicine, a new biomedical discipline that uses a person's genetic profile to guide clinical decisions regarding the prevention, diagnosis or treatment of a disease.