Variability in clinical laboratory practice in testing for disorders of platelet function

Karen A. Moffat; Marlies R. Ledford-Kraemer; William L. Nichols; Catherine P. M. Hayward

doi:10.1160/TH04-10-0670

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2005; 93(03): 549-553
DOI: 10.1160/TH04-10-0670

Platelets and Blood Cells

Schattauer GmbH

Variability in clinical laboratory practice in testing for disorders of platelet function

Results of two surveys of the North American Specialized Coagulation Laboratory Association

Authors

Karen A. Moffat

¹Hamilton Regional Laboratory Medicine Program, Haematology, Hamilton, Ontario, Canada

²North American Specialized Coagulation Laboratory Association, USA
Marlies R. Ledford-Kraemer

²North American Specialized Coagulation Laboratory Association, USA

³CLOT-ED Inc, Islamorada, Florida, USA

⁴University of Miami School of Medicine, Miami, Florida, USA
William L. Nichols

²North American Specialized Coagulation Laboratory Association, USA

⁵Mayo Clinic, Rochester, Minnesota, USA
Catherine P. M. Hayward

¹Hamilton Regional Laboratory Medicine Program, Haematology, Hamilton, Ontario, Canada

²North American Specialized Coagulation Laboratory Association, USA

⁶McMaster University, Pathology and Molecular Medicine and Medicine, Hamilton, Ontario, Canada

Abstract

Summary

Disorders of platelet function are important causes of abnormal bleeding that require laboratory tests for diagnosis. Currently there are limited guidelines on how to perform clinical testing for these disorders. The goal of our study was to obtain information on how disorders of platelet function are currently evaluated in clinical laboratories. Two patterns-of-practice surveys were distributed to laboratories of the North American Specialized Coagulation Laboratory Association (NASCOLA). The information collected was analyzed to determine practices and common problems. Forty-seven NASCOLA laboratories participated and 54% completed both surveys. The majority of the laboratories that responded performed more than 50 aggregation tests per year, mainly using platelet rich plasma based methodologies. A minority performed testing for platelet secretion and dense granule abnormalities. While platelet aggregation results were reviewed in various ways, laboratories most commonly issued a combined report containing quantitative values (% aggregation and/or slope) and a qualitative interpretation. Although laboratories used similar agonists for aggregation testing, the final agonist concentrations varied widely. Several approaches were also used to obtain reference intervals. Comments offered by the participants indicated that performing, and interpreting platelet function tests were challenging for many clinical laboratories. Although common practices have evolved, there is considerable variability in the diagnostic test procedures used by clinical laboratories to evaluate disorders of platelet function. These patterns-of-practice surveys illustrate a need for guidelines and recommendations for clinical laboratories performing tests of platelet function.

Keywords

Platelet disorders - platelet function testing - platelet secretion

Full Text

References

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