Testing for lupus anticoagulants–fresh or frozen?
Abstract
BACKGROUND: There are no previous studies reporting the effect of using frozen-thawed plasma on lupus anticoagulant ratios in kits with the combined screen and confirm assay. METHODS: In the following study we chose patients with elevated dilute Russel's viper venom test (dRVVT) normalized ratios and compared the test results of fresh to frozen-thawed plasma. Platelet counts ranged from 2 to 7×10(3)/μL (10(9)/L) after a second centrifugation before freezing. RESULTS: There were 13 out of 14 dRVVT test normalized ratios that decreased after freezing (p<0.001), leading to the misclassification of six of 14 patients with high values that decreased into the reference interval. CONCLUSION: The major finding of this study is that testing frozen-thawed plasma with platelet counts <10,000/μL (10(9)/L) results in a significant decrease in dRVVT ratios. Although there was a consistent decrease in SCT normalized ratios as well, it did not lead to misclassifications.
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Freeze-thawing can increase diluted Russell's viper venom time ratios and lead to false-negative LA results.
“The effect of freeze-thawing on diluted Russell's viper venom time (dRVVT) ratios leading to false-negative results was confirmed in a more recent study.28”
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Devreese, K. M. J., de Groot, P. G., de Laat, B., Erkan, D., Favaloro, E. J., Mackie, I., Martinuzzo, M., Ortel, T. L., Pengo, V., Rand, J. H., et al. (2020) · Journal of Thrombosis and Haemostasis · doi:10.1111/jth.15047 · Cited by 439 · see citing works
Favaloro, E. J., & Wong, R. C. W. (2014) · Pathology · doi:10.1097/pat.0000000000000142 · Cited by 75 · see citing works
Testing for Lupus Anticoagulants
Moore, G. W. (2022) · Seminars in Thrombosis and Hemostasis · doi:10.1055/s-0042-1744363 · Cited by 30 · see citing works
Impact of different preanalytical conditions on results of lupus anticoagulant tests
Kristoffersen, A. H., Hammer, I. J., Vannes, S., Åsberg, A., & Aakre, K. M. (2019) · International Journal of Laboratory Hematology · doi:10.1111/ijlh.13102 · Cited by 14 · see citing works
Foshat, M., Bates, S. T., Russo, W. L., et al. (2014) · Clinical and Applied Thrombosis/Hemostasis · doi:10.1177/1076029614535973 · Cited by 13 · see citing works
“In a second study, they demonstrated samples frozen at 80 C have decreased DRVVT test ratios which lead to misclassification of 6 patients regardless of freezing time length (16-75 days).(17) In contrast, our study found no significant change in DRVVT in both the healthy and coagulopathic groups which may be due to a…”
MethodResultAutovalidation rates in an outpatient coagulation laboratory
Froom, P., Saffuri-Elias, E., & Barak, M. (2015) · International Journal of Laboratory Hematology · doi:10.1111/ijlh.12386 · Cited by 8 · see citing works
“We were able to implement this practice after demonstrating that functional lupus anticoagulant tests are stable for up to 6–8 h [4] and that testing fresh plasma after a single centrifugation is preferable to testing thawed samples that require double centrifugation to lower the platelet counts before freezing [5].”
MethodSelf-citationGaudard, M., Boissier, E., Talon, L., et al. (2022) · International Journal of Laboratory Hematology · doi:10.1111/ijlh.13794 · Cited by 7 · see citing works
Recent advances in laboratory hematology reflected by a decade of CCLM publications
Hoffmann, J. J. M. L., & Urrechaga, E. (2022) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2022-0962 · Cited by 6 · see citing works
The association of serum antiphospholipid antibodies and dilute Russell's viper venom times
Froom, P., Saffuri-Elias, E., Rozenberg, O., & Barak, M. (2013) · Journal of Clinical Pathology · doi:10.1136/jclinpath-2013-201830 · Cited by 6 · see citing works
Self-citationViewpoint: Lupus anticoagulant detection and interpretation in antiphospholipid syndrome
Efthymiou, M., Bertolaccini, M. L., & Cohen, H. (2024) · Rheumatology · doi:10.1093/rheumatology/kead623 · Cited by 5 · see citing works
Quality in Hemostasis and Thrombosis, Part II
Plebani, M., Favaloro, E. J., & Lippi, G. (2013) · Seminars in Thrombosis and Hemostasis · doi:10.1055/s-0033-1334446 · Cited by 5 · see citing works
Quality in Hemostasis and Thrombosis — Part III
Favaloro, E. J., Lippi, G., & Plebani, M. (2014) · Seminars in Thrombosis and Hemostasis · doi:10.1055/s-0034-1370785 · Cited by 3 · see citing works
Triple positive antiphospholipid antibody profile in outpatients with tests for lupus anticoagulants
Froom, P., Saffuri-Elias, E., Rozenberg, O., & Barak, M. (2014) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2014-0571 · Cited by 3 · see citing works
“First of all, testing fresh samples limited the variability in functional LAC testing that may be introduced by freezing and thawing [9].”
BackgroundSelf-citation
- Authors
- Froom, P., & Barak, M.
- Affiliations
- Clalit Health Services (IL)
- Corresponding author
- Froom, Paul
- ORCID
- Froom, Paul
- Venue
- Clinical Chemistry and Laboratory Medicine (CCLM)
- Publisher
- Walter de Gruyter GmbH
- Published
- 2012-09-01
- Volume
- 50
- Issue
- 9
- Pages
- 1607-9
- ISSN
- 1434-6621 (ISSN-L)
- 1437-4331
- OpenAlex
- W2002795993
- Cited by
- 15
- References
- 0
- Citations by year
- 2024: 1 · 2023: 1 · 2022: 3 · 2020: 1 · 2019: 1 · 2015: 1 · 2014: 4 · 2013: 3
- FWCI
- 1.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Chemistry and Laboratory Medicine (CCLM) (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Keywords
- lupus anticoagulant, fresh plasma, platelet count, misclassification
- MeSH terms
- Freezing, Humans, Platelet Count, Prothrombin Time, Lupus Coagulation Inhibitor
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