Standardization of Light Transmission Aggregometry for the diagnosis of inherited platelet function disorders: First inter-laboratory external quality assessment in Germany and Austria
ISTH Academy. Althaus K. Jul 9, 2019; 264513; PB1322 Topic: Laboratory Diagnostics - Platelet
Dr. Karina Althaus
Dr. Karina Althaus
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PB1322

Standardization of Light Transmission Aggregometry for the Diagnosis of Inherited Platelet Function Disorders: First Inter-laboratory External Quality Assessment in Germany and Austria

K. Althaus1, B. Zieger2, T. Bakchoul3,4, K. Jurk5, Thromkid-Plus Studiengruppe (GTH)
1Universitätsklinikum Tübingen, Center for Clinical Transfusion Medicine, Tuebingen, Germany, 2University of Freiburg, Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology and Oncology, Medical Center, Freiburg, Germany, 3University Hospital Tuebingen, Center for Clinical Transfusion Medicine, Tuebingen, Germany, 4Medical Faculty of Tuebingen, Transfusion Medicine, Tuebingen, Germany, 5University Medical Center of the Johannes Gutenberg University, Center for Thrombosis and Hemostasis (CTH), Mainz, Germany

Main Topic: Diagnostics and OMICs
Category: Laboratory Diagnostics – Platelet

Background: Several in vitro platelet function tests are available for the diagnosis of inherited platelet function disorders. Currently, the light transmission aggregometry (LTA) is recommended as one of first-step tests, which are available in most clinical centers. Although the LTA is accepted as a 'gold standard' assay for the evaluation of platelet function, its standardization in the clinical practice is still challenging. The GTH-based THROMKID-Plus Study Group has created a standard and a quality management of the LTA and performed an inter-laboratory survey in Germany and Austria.
Aims: The aim was to provide a practical, achievable and affordable external quality control, with easy handling and high reliability of standardization.
Methods: Five different agonists (stable at 4°C) were selected according to the SSC/ISTH recommendations and shipped for three different sets (healthy control, simulated platelet function disorders) to 15 specialised laboratories in Germany and Austria. Agonists were analysed in the APACT or PAP4/8 aggregometer using platelet-rich plasma of a healthy donor from each lab. In addition, lab-internal platelet agonists were tested in platelet-rich plasma from a healthy donor.
Results: All laboratories (9 APACT/6 PAP4/PAP8) showed very consistent data regarding the maximum percentage of aggregation induced by the tested agonists and identified the differential diagnosis of the simulated platelet function disorders with one exception, which was due to technical problems. In contrast, there was a high variability of the lab-internal inductors regarding reagent type, concentrations and pathological cut-off values.
Conclusions: The shipment of agonists is suitable for an inter-laboratory survey of LTA. However, there are still persistent needs for standardisation of agonist reagents and their concentration ranges as well as for definition of reference ranges.

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