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Influencing factors and differences in Born aggregometry in specialized hemostaseological centers – results of a multi-center laboratory comparison.Influencing factors and differences in Born aggregometry in specialized hemostaseological centers – results of a multi-center laboratory comparison.
Abstract: Introduction Light transmission aggregometry (LTA) is regarded as the gold standard in platelet function diagnostics. However, there is a relevant degree of inter-laboratory 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 carried out on 30 subjects in total. Each center performed LTA on blood samples from six healthy volunteers (three men and three women) using the inductors collagen, ADP, arachidonic acid, and ristocetin. The LTA was performed three times using different methods: (A) International Society on Thrombosis and Haemostasis (ISTH) recommendations with identical reagents; (B) in-house protocols and the identical reagents; and (C) 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; p < 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 collagen and ristocetin; there were significant influences from the reagents’ manufacturers in the results of aggregometry for the inductor collagen (p < 0.01) but not for ADP, arachidonic acid, and ristocetin. Conclusions 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.
Received: 24 November 2021
Accepted after revision: 14 February 2022
Accepted Manuscript online:
18 April 2022
© 2022. 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/).
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