TY - JOUR
T1 - Recommendations for appropriate activated partial thromboplastin time reagent selection and utilization
AU - Fritsma, George A.
AU - Dembitzer, Francine R.
AU - Randhawa, Ankush
AU - Marques, Marisa B.
AU - Van Cott, Elizabeth M.
AU - Adcock-Funk, Dorothy
AU - Peerschke, Ellinor I.
PY - 2012/6
Y1 - 2012/6
N2 - The activated partial thromboplastin time (aPTT) is widely used as a screening coagulation test and for monitoring unfractionated heparin therapy. Various commercial reagents are available, with different performance characteristics, particularly responsiveness to the lupus anticoagulant (LA). Because aPTT reagent selection significantly affects the interpretation of results, we reviewed College of American Pathologists proficiency testing data involving approximately 4,000 coagulation laboratories, and conducted a survey of coagulation laboratories (n = 93) using The Fritsma Factor hemostasis Web site to determine the basis for aPTT reagent selection. The data demonstrate that for routine aPTT testing, most laboratories use reagents with high/moderate responsiveness to LA. Significant misunderstanding was apparent regarding the use of appropriate aPTT reagent for routine testing and LA identification. We recommend aPTT reagents with low LA responsiveness to screen for coagulation factor deficiencies and heparin monitoring, and suggest continued education of laboratory professionals and reagent manufacturers about appropriate aPTT reagent use.
AB - The activated partial thromboplastin time (aPTT) is widely used as a screening coagulation test and for monitoring unfractionated heparin therapy. Various commercial reagents are available, with different performance characteristics, particularly responsiveness to the lupus anticoagulant (LA). Because aPTT reagent selection significantly affects the interpretation of results, we reviewed College of American Pathologists proficiency testing data involving approximately 4,000 coagulation laboratories, and conducted a survey of coagulation laboratories (n = 93) using The Fritsma Factor hemostasis Web site to determine the basis for aPTT reagent selection. The data demonstrate that for routine aPTT testing, most laboratories use reagents with high/moderate responsiveness to LA. Significant misunderstanding was apparent regarding the use of appropriate aPTT reagent for routine testing and LA identification. We recommend aPTT reagents with low LA responsiveness to screen for coagulation factor deficiencies and heparin monitoring, and suggest continued education of laboratory professionals and reagent manufacturers about appropriate aPTT reagent use.
KW - Activated partial thromboplastin time
KW - Lupus anticoagulant
KW - Reagent
KW - Routine coagulation
KW - aPTT
UR - http://www.scopus.com/inward/record.url?scp=84863767302&partnerID=8YFLogxK
U2 - 10.1309/AJCP3J1ZKYBFQXJM
DO - 10.1309/AJCP3J1ZKYBFQXJM
M3 - Article
C2 - 22586049
AN - SCOPUS:84863767302
SN - 0002-9173
VL - 137
SP - 904
EP - 908
JO - American Journal of Clinical Pathology
JF - American Journal of Clinical Pathology
IS - 6
ER -