Subscribe to RSS
DOI: 10.1055/s-0038-1648850
Results of a Multicenter Study Assessing the Status of Standardization of a Recombinant Thromboplastin for the Control of Oral Anticoagulant Therapy
Publication History
Received: 18 January 1994
Accepted after revision06 April 1994
Publication Date:
24 July 2018 (online)
Summary
An international collaborative study involving 20 laboratories was undertaken to evaluate the status of standardization of a commerical recombinant thromboplastin. The results show that the reagent fulfills the WHO requirements for thromboplastin calibration against two International Reference Preparations (IRP) from different species, because there was a linear relationship of log-transformed prothrombin times as measured by the recombinant reagent and the two IRPs in normal individuals and patients stabilized on oral anticoagulants. The regression lines drawn through the patient data points passed through the normal data points in the majority of instances. The average ISI values for three different batches were close to unity. On the average, the ISI value calculated against BCT/253 (human, plain) was slightly smaller than that against RBT/79 (rabbit, plain). The between laboratory precision of calibration (CV = 5-6%) did not change whether BCT/253 or RBT/79 was used, whereas it was substantially improved when the calibrations of batches 2 and 3 were performed against batch 1, arbitrarily taken as standard (CV ≤ 1.7%). Statistical analysis to test for differences between slopes revealed no significant between-batch differences in 16 of 20 laboratories. However slight differences for the third batch (2.8% less than the average ISI value of batches 1 and 2) leave room for further improvement in the standardization of the reagent.
-
References
- 1 Edgington TS, Mackman N, Brand K, Ruf W. The structural biology of expression and function of tissue factor. Thomb Haemost 1991; 66: 67-79
- 2 Paborski LR, Tate KM, Harris RJ, Yansura DG, Band L, Me Gray G, Gorman CM, O’Brien DP, Chang JY, Swartz JR, Fung VP, Thomas JN, Vehar GA. Purification of recombinant human tissue factor. Biochemistry 1989; 28: 8072-8077
- 3 Rehemtulla A, Pepe M, Edgington TS. High level expression of recombinant human tissue factor in Chinese hamster ovary cells as a human thromboplastin. Thromb Haemost 1991; 65: 521-527
- 4 Tripodi A, Arbini A, Chantarangkul V, Mannucci PM. Recombinant tissue factor as substitute for conventional thromboplastin in the prothrombin time test. Thromb Haemost 1992; 67: 42-45
- 5 World Health Organization. Recommended methodology for using WHO International Reference Preparations for thromboplastins. Available from World Health Organization, 1211 Geneva 27, Switzerland
- 6 WHO Expert Committee on Biological Standardization. Thirty-third Report. Technical Report Series 687. WHO, Geneva 1983
- 7 Tomenson JA. A statistician’s independent evaluation. AMHP van den Besselaar, HR Gralnick, SM Lewis (eds.). Martinus Nijhoff Publishers, Boston 1984: 87-108
- 8 Reijnierse GLA, van den Besselaar AMHP, Hermans J. Een nieuw verwer-kingsprogramma van ingezonden uitslagen in het kader van exteme kwali-teitsbewaking. Evaringen in 1988. TijdschrNVKC 1989; 14: 122-127
- 9 van den Besselaar AMHP, Bertina RM. Multi-center study of thromboplastin calibration, precision-influence of reagent species, composition, and International Sensitivity Index (ISI). Thromb Haemost 1993; 69: 35-40
- 10 Hermans J, van den Besselaar AMHP, Loeliger EA, van der Velde EA. A collaborative calibration study of reference materials for thromboplastins. Thromb Haemost 1983; 50: 712-717
- 11 Thomson JM, Tomenson JA, Poller L. The calibration of the Second Primary International Reference Preparation for thromboplastin (Thromboplastin, Human, Plain, coded BCT/253). Thromb Haemost 1984; 52: 336-342
- 12 Kirkwood TBL. Calibration of reference thromboplastins and standardization of the prothrombin time ratio. Thromb Haemost 1983; 49: 238-244
- 13 Palareti G, Coccheri S, Poggi M, Bonetti M, Cervi V, Mazzucca A, Savoia M, Veri L, Fiori F, Gaspari G, Palareti A. Oral anticoagulant therapy control: evidence that INR expression improves the interlaboratory comparability of results. The Bologna oral anticoagulant control exercise. Thromb Haemost 1987; 58: 905-910
- 14 Hirsh J, Levine M. Confusion over therapeutic range for monitoring oral anticoagulant therapy in North America. Thromb Haemost 1988; 59: 129-132
- 15 Thomson JM, Darby KV, Poller L. Calibration of BCT/441, the ICSH Reference Preparation for thromboplastin. Thromb Haemost 1986; 55: 379-382
- 16 van den Besselaar AMHP, Berina RM. Multi-center calibration of the Second Reference Material for thromboplastin, Rabbit, Plain, coded CRM 149R. Thromb Haemost 1991; 65: 263-267
- 17 Loeliger EA, van den Besselaar AMHP, Lewis SM. Reliability and clinical impact of the normalization of the prothrombin times in oral anticoagulant control. Thromb Haemost 1985; 53: 148-154
- 18 Poller L, Taberner DA, Thomson JM, Morris J, Mibashan RS, Shinton NK. Effect of the choice of WHO International Reference Preparation for thromboplastin on International Normalized Ratio. J Clin Path 1993; 46: 64-66
- 19 van den Besselaar AMHP. Multi-center study of replacement of the International Reference Preparation for thromboplastin, rabbit, plain. Thromb Haemost 1993; 70: 794-799