Influencing Factors and Differences in Born Aggregometry in Specialized Hemostaseological Centers: Results of a Multicenter Laboratory Comparison

Thorsten Kaiser; Karin Liebscher; Ute Scholz; Christian Pfrepper; Jeffrey Netto; Tim Drogies; Oliver Tiebel; Ralf Knöfler; Michael Krause

doi:10.1055/a-1827-7025

Influencing Factors and Differences in Born Aggregometry in Specialized Hemostaseological Centers: Results of a Multicenter Laboratory Comparison

TH Open. 2022 Aug 22;6(3):e213-e220. doi: 10.1055/a-1827-7025. eCollection 2022 Jul.

Authors

Thorsten Kaiser¹, Karin Liebscher², Ute Scholz³, Christian Pfrepper⁴, Jeffrey Netto¹, Tim Drogies⁵, Oliver Tiebel⁶, Ralf Knöfler⁷, Michael Krause³

Affiliations

¹ Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Paul-List-Str., Leipzig, Germany.
² Institute of Transfusion Medicine and Clinical Hemostaseology, Klinikum St. Georg gGmbH, Delitzscher Straße, Leipzig, Germany.
³ MVZ Laboratory Reising-Ackermann MD and Colleagues, Strümpellstraße, Leipzig, Germany.
⁴ Division of Hemostaseology, University Hospital Leipzig, Liebigstraße, Leipzig, Germany.
⁵ Medical Central Laboratory Altenburg, Am Waldessaum, Altenburg, Germany.
⁶ Institute of Clinical Chemistry and Laboratory Medicine, Medical Faculty of Technical University, Dresden, Germany.
⁷ Department of Paediatric Haemostaseology, University Hospital Carl Gustav Carus, Dresden, Germany.

Abstract

Introduction Light transmission aggregometry (LTA) is regarded as the gold standard in platelet function diagnostics. However, there is a relevant degree of interlaboratory variability in practical applications. Objective The aim of the present study was to develop a practicable laboratory comparison on LTA and to analyze differences and influencing factors in regard to standardization in five specialized hemostaseological centers. Methods The study was performed on 30 patients in total. Each center performed LTA on blood samples from six healthy volunteers (three men and three women) using the inductors collagen (Col), adenosine diphosphate (ADP), arachidonic acid (ARA), and ristocetin. The LTA was performed three times using different methods as follows: (1) International Society on Thrombosis and Haemostasis recommendations with identical reagents, (2) in-house protocols and the identical reagents; and (3) in-house protocols and in-house reagents. Results A total of 396 measurements of 30 probands were performed. Even after standardization of the protocol and using identical reagents, there were significant differences between the centers regarding the final and maximum aggregation ( p = 0.002 and <0.001) and further significant differences in the maximum and final aggregation according to the wavelength of the device used to measure the LTA (PAP-8: 430 nm, APACT 4004: 740 nm [ p < 0.001 each]). Using identical reagents but individual inductor concentrations and laboratory protocols also resulted in different maximum and final aggregation. The largest differences were seen with Col and ristocetin; there were significant influences from the reagents' manufacturers in the results of aggregometry for the inductor Col ( p < 0.01) but not for ADP, ARA, and ristocetin. Conclusion In this study, we proved that there are significant influences from the used aggregometers, inductors concentrations, and manufacturers. These results illustrate the challenges and importance of standardization of LTA.

Keywords: inherited/acquired platelet disorders; platelet glycoproteins; platelet immunology; platelet physiology.

The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. ( https://creativecommons.org/licenses/by/4.0/ ).