TY - JOUR
T1 - Should multiple factor dilutions be performed for all patient coagulation factor assays?
T2 - Let the debate begin!
AU - Favaloro, Emmanuel J
AU - Pasalic, Leonardo
N1 - Funding Information:
There was no specific funding for this work. NSW Health Pathology, as the employer of the authors, is acknowledged for in-kind support that permits some allocation of time for scientific research. The authors thank various current and past employees of NSW Health Pathology for past contributions that have helped to shape the current article.
Publisher Copyright:
© 2022 The Authors. Research and Practice in Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis (ISTH).
PY - 2022/2
Y1 - 2022/2
N2 - Laboratory assessment of blood coagulation factors may be undertaken for various reasons, including investigating the possibility of hemophilia or unexpected prolongation in routine coagulation assays (eg, prothrombin time, activated partial thromboplastin time). Several guidelines recommend performing multiple dilutions (usually 2-3) on all patient test samples to evaluate "parallelism" as a guide to the presence of potential "inhibitors," be they factor inhibitors, lupus anticoagulant, or related to the presence of anticoagulant therapy. The current Forum argues against mandating investigation of parallelism (or multiple dilutions) for all samples destined for testing, instead suggesting that a more targeted approach will likely provide better clinical utility and use of laboratory resources.
AB - Laboratory assessment of blood coagulation factors may be undertaken for various reasons, including investigating the possibility of hemophilia or unexpected prolongation in routine coagulation assays (eg, prothrombin time, activated partial thromboplastin time). Several guidelines recommend performing multiple dilutions (usually 2-3) on all patient test samples to evaluate "parallelism" as a guide to the presence of potential "inhibitors," be they factor inhibitors, lupus anticoagulant, or related to the presence of anticoagulant therapy. The current Forum argues against mandating investigation of parallelism (or multiple dilutions) for all samples destined for testing, instead suggesting that a more targeted approach will likely provide better clinical utility and use of laboratory resources.
KW - activated partial thromboplastin time
KW - anticoagulants
KW - blood coagulation factors
KW - inhibitors
KW - lupus anticoagulant
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U2 - 10.1002/rth2.12689
DO - 10.1002/rth2.12689
M3 - Comment/debate
C2 - 35308100
SN - 2475-0379
VL - 6
JO - Research and Practice in Thrombosis and Haemostasis
JF - Research and Practice in Thrombosis and Haemostasis
IS - 2
M1 - e12689
ER -