Validation of whole blood impedance aggregometry as a new diagnostic tool for HIT: results of a large Australian study

Morel-Kopp, Marie-Christine, Tan, Chee Wee, Brighton, Timothy A., McRae, Simon, Baker, Ross, Huyen Tran, Mollee, Peter, Kershaw, Geoffrey, Joseph, Joanne and Ward, Christopher (2012) Validation of whole blood impedance aggregometry as a new diagnostic tool for HIT: results of a large Australian study. Thrombosis and Haemostasis, 107 3: 575-583. doi:10.1160/TH11-09-0631


Author Morel-Kopp, Marie-Christine
Tan, Chee Wee
Brighton, Timothy A.
McRae, Simon
Baker, Ross
Huyen Tran
Mollee, Peter
Kershaw, Geoffrey
Joseph, Joanne
Ward, Christopher
Title Validation of whole blood impedance aggregometry as a new diagnostic tool for HIT: results of a large Australian study
Journal name Thrombosis and Haemostasis   Check publisher's open access policy
ISSN 0340-6245
Publication date 2012-03
Year available 2012
Sub-type Article (original research)
DOI 10.1160/TH11-09-0631
Open Access Status Not Open Access
Volume 107
Issue 3
Start page 575
End page 583
Total pages 9
Place of publication Stuttgart, Germany
Publisher Schattauer
Language eng
Abstract Heparin-induced thrombocytopenia (HIT) remains a challenge, with diagnosis confirmed only by functional assays. The gold standard 14C-serotonin release assay (SRA) is highly sensitive but technically challenging and unsuitable for routine use. We conducted a large study to validate whole blood impedance aggregometry (WBIA) as a suitable diagnostic tool for HIT. WBIA and SRA were used to test 181 samples positive for H-PF4 antibodies by PaGIA or ELISA. Using the same high responder donor, 77 samples were positive by WBIA (aggregation with low-dose but not high-dose heparin). Using the strict definition for SRA positivity, 72 samples were true HIT. In nine samples, serotonin release with high-dose heparin dropped by > 50% but was still >20%; these were retested after a one-half dilution and 8/9 became positive. Ten other samples were discrepant between the two assays: one strongly positive (89% release) and six weakly positive samples by SRA (average release 56%) were WBIA negative. When these samples were retested using a random donor, only two remained SRA positive. Three samples were strongly WBIA positive but SRA negative; two were retested by SRA with 0.5IU/ml heparin and one became positive. Under controlled conditions, using the same selected high-responder donor, WBIA and SRA performed similarly with slightly increased sensitivity of the WBIA when using the strict definition of SRA positivity. WBIA is easy to perform with rapid turn-around time and warrants a multi-laboratory trial to complete its validation as a confirmatory assay for platelet-activating HIT antibodies.
Keyword Heparin-induced thrombocytopenia
Heparin
Serotonin release assay
4T's score
Whole blood impedance aggregometry
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 14 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 17 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Fri, 01 May 2015, 18:32:38 EST by System User on behalf of School of Medicine