CC BY 4.0 · TH Open 2023; 07(01): e56-e64
DOI: 10.1055/s-0043-1762588
Original Article

Automated Light Transmission Aggregometry with and without Platelet Poor Plasma Reference: A Method Comparison

Ulrich J. Sachs
1   Department of Thrombosis and Haemostasis, Giessen University Hospital, Giessen, Germany
2   Institute for Clinical Immunology, Transfusion Medicine, and Haemostaseology, Justus Liebig University, Giessen, Germany
Lida Röder
2   Institute for Clinical Immunology, Transfusion Medicine, and Haemostaseology, Justus Liebig University, Giessen, Germany
Nina Cooper
2   Institute for Clinical Immunology, Transfusion Medicine, and Haemostaseology, Justus Liebig University, Giessen, Germany
Christian Radon
3   Behnk Elektronik, Norderstedt, Germany
Hans-Jürgen Kolde
4   Consulting Diagnostics, Seefeld, Germany
› Author Affiliations
Funding This work was supported by Behnk Elektronik GmbH & Co.KG, 22851 Norderstedt, Germany.


Background Light transmission aggregometry (LTA) is considered the gold standard for the evaluation of platelet function but is labor-intensive and involves numerous manual steps. Automation may contribute to standardization. Here, we evaluate the performance characteristics of a new automated instrument, Thrombomate XRA (TXRA), and compare it against a manual instrument (PAP-8).

Materials and Methods Leftover blood samples from blood donors or patients were tested in parallel with identical reagents and in identical concentrations both manually using PAP-8 and automated on the TXRA. In addition to precision and method comparison, an additional evaluation was performed on the TXRA against “virtual” platelet-poor plasma (VPPP) based on artificial intelligence. The main focus was on comparing the maximum aggregation (MA%) values.

Results Precision for MA% ranged from 1.4 to 4.6% on TXRA for all reagents. Normal ranges for 100 healthy blood donors on both instruments were in a similar range for all reagents, with a tendency to slightly higher values with TXRA. Most agonists resulted in normally distributed MA%. Comparing 47 patient samples on both devices showed a good correlation for both slope and MA% with some differences in individual samples with epinephrine and TRAP. Correlation between the TXRA measurement against PPP and “virtual” PPP demonstrated excellent correlation. Reaction signatures of both devices were very similar.

Conclusion TXRA provides reproducible LTA results that correlate with an established manual method when tested against PPP or VPPP. Its ability to perform LTA only from platelet-rich plasma without requiring autologous PPP simplifies LTA. TXRA is an important step not only for further standardizing LTA but also for a more widespread use of this important method.

Publication History

Received: 02 September 2022

Accepted: 22 December 2022

Article published online:
22 February 2023

© 2023. 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. (

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