Activation Assays Using Citrate Anticoagulated Blood

The first reports describing the use of normal donor c-PRP to detect platelet activation caused by HIT serum or plasma appeared in the 1970s (Rhodes et al., 1973; Fratantoni et al., 1975; Babcock et al., 1976). A ratio of serum (or plasma) to c-PRP between 0.66 and 1.0 was used (e.g., 200 mL serum added to 200-300 mL c-PRP). No standardized method has evolved, however, although a survey of 54 laboratories in France (Nguyen et al., 1994) found some practices to be more common. For example, most laboratories test patient citrated platelet-poor plasma (c-PPP) rather than heat-inactivated serum. Variable heparin concentrations are used, most commonly between 0.5 and 1.0U/mL. The ratio of patient c-PPP to donor c-PRP is usually 1:1, and ABO discrepancies are usually ignored. About 75% of the laboratories use at least two platelet donors for diagnostic testing.

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