ABSTRACT
Decreased retention in the retention test Homburg (RTH) indicates a loss of platelet
function; increase is associated with an increased activation of platelets, for example,
in patients with vascular diseases. Compared with other materials (e.g., collagen,
glass pearls, etc.) the filter surface in the retention tubes is nonthrombogenic.
Therefore, the RTH seems to be well suited for measuring an in vivo over-reactivity
of platelets. In a pilot study using the RTH we evaluated the postoperative over-reactivity
of platelets in 14 patients and observed a significant heterogeneity of the platelet
population concerning size and stickiness.
Reliable platelet function tests are also necessary for “drug monitoring,” since they
deliver important clinical laboratory parameters for efficient control of a therapy
with antiplatelet drugs. Therefore, we evaluated in vitro how, after administration
of platelet aggregation-inhibiting medications (such as acetylsalicylic acid, Prostaglandin®, and ReoPro®) in various concentrations, the adenosine diphosphate (ADP), collagen, ristocetin,
or suprarenin increased retention can be reduced.
The reaction of the platelets in platelet-rich plasma of different patients or donors
to the addition of ADP is variable. The platelet function inhibitor effect is dose
dependent.
In a clinical pilot study, a significant platelet-inhibiting effect of clopidogrel
using the RTH has been shown.
KEYWORDS
Retention test - platelet hyperactivity - drug monitoring - clopidogrel
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Boris KrischekM.D.
Department of Neurosurgery, Philipps University Hospital, Baldingerstrasse
35033 Marburg, Germany
Email: krischek@med.uni-marburg.de
Email: boris@krischek.de
