Why the study?
Light transmission aggregometry is the gold standard for evaluating platelet function, but substantial protocol and result variation exists, prompting efforts to establish a standardized national protocol.
Does implementing a standardized LTA protocol based on the SSC guideline reduce variability in platelet aggregation results in healthy volunteers?
Observational (n=263)
Yes
Does implementing a standardized LTA protocol based on the SSC guideline reduce variability in platelet aggregation results in healthy volunteers?
Standardizing light transmission aggregometry protocols based on SSC guidelines reduces variability for high agonist concentrations but not for low concentrations in healthy volunteers.
Light transmission aggregometry (LTA) is considered the gold standard method for evaluation of platelet function. However, there are a lot of variation in protocols (pre-analytical procedures and agonist concentrations) and results. The aim of our study was to establish a national LTA protocol, to investigate the effect of standardization and to define national reference values for LTA. The SSC guideline was used as base for a national procedure. Almost all recommendations of the SSC were followed e.g. no adjustment of PRP, citrate concentration of 109 mM, 21 needle gauge, fasting, resting time for whole blood and PRP, centrifugation time, speed and agonists concentrations. LTA of healthy volunteers was measured in a total of 16 hospitals with 5 hospitals before and after standardization. Results of more than 120 healthy volunteers (maximum aggregation %) were collected, with participating laboratories using 4 different analyzers with different reagents. Use of low agonist concentrations showed high variation before and after standardization, with the exception of collagen. For most high agonist concentrations (ADP, collagen, ristocetin, epinephrine and arachidonic acid) variability in healthy subjects decreased after standardization. We can conclude that a standardized Dutch protocol for LTA, based on the SSC guideline, does not result in smaller variability in healthy volunteers for all agonist concentrations.
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Munnix et al. (2020) conducted an observational in Healthy volunteers (Evaluating Platelet Function Testing) (n=263). Standardized light transmission aggregometry (LTA) protocol based on SSC-ISTH guideline vs. Local, unstandardized LTA protocols was evaluated on Variability in maximum platelet aggregation for various agonist concentrations. Implementation of a standardized Dutch protocol for light transmission aggregometry decreased variability in maximum aggregation for most high agonist concentrations, but did not reduce variability for all agonist concentrations in healthy volunteers.
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