Pre-analytical stability of blood samples transported by drone versus ground: a pilot study

Pre-analytical conditions are critical to ensure the reliability of laboratory results, as emphasized by ISO 15189 standards. Drone transport has emerged as a promising alternative to conventional logistics, but its impact on sample integrity remains insufficiently characterized. This pilot study aimed to assess the pre-analytical stability of blood samples transported by drone versus ground transport.

In this prospective study, 30 healthy volunteers were included. Six blood tubes per participant were collected simultaneously and assigned to ground or drone transport (20 min). A panel of 23 biochemical, hematological, and hemostatic parameters was analyzed. Agreement between transport modalities was assessed using paired comparisons, coefficients of variation, intraclass correlation coefficients (ICC), Pearson correlation, and Bland-Altman analysis.

No clinically meaningful differences were observed between transport modalities. Mean values and variability were comparable across parameters. Most analytes showed excellent agreement, with ICC and Pearson correlation coefficients >0.90. Although ALT and LDH showed statistically significant differences (p = 0.039), these were small and clinically negligible. Bland-Altman analysis confirmed minimal bias for ALT (-0.63 U/L), whereas LDH exhibited wider limits of agreement, suggesting increased sensitivity to transport-related factors (-9.7 U/L). No hemolysis, temperature deviation, or safety incidents were observed.

Drone transport ensures robust pre-analytical stability of blood samples across a wide range of laboratory parameters. However, analyte-specific variability, particularly for LDH, highlights the need for targeted validation. These findings support the integration of drone-based logistics into laboratory workflows, while emphasizing the importance of analyte-dependent evaluation.