Abstract: PB2089
Type: Publication Only
Background
Transfusion enhanced many kind of complication in patients therefore peri-operative coagulation monitoring was suggested before the surgical procedure to protect the patients against bleeding. Also there are some diseases which had bleeding events in surgical procedure or spontaneously. We should detect these kind of diseases and we should examine the correct measure of active parsiel thromboplastin time (APTT) before surgical procedure by detecting the mild ormoderate deficiencies of plasma factor levels and by eliminating the lupus antıcougulant from plasma. This was caused to make the importance of APTT reagents .
Aims
We tried to show the importance of APTT reagents and how to reach the correct measure of APTT in this study.
Methods
We are planning to examine 300 patients, 109 of 300 patients were included as yet. Patient’s APTT levels were calculated ACL-TOP analyzer by using three different reagents.First reagent was HemosILAPTT-SP which was sensitive against both plasma factors and lupus anticoagulant. It contains mix collodial silica and normal range of APTT- SP was 25.4-36.9 s. Second reagent was HemosIL SynthASil-SS which was sensitive against only plasma factors.It contains silica and normal range of APTT-SS was 25.1-36.5 s. The third reagent was HemosIL SynthA Fox-SF which was sensitive against only lupus anticoagulant. It contains ellagic asid and normal range of APTT-SF was 21.5-30.4 s.
Results
Forthy-five of 109 patients had normal level of APTT by measuring three types of reagents. Seventeen of 109 patients had long level of APTT by measuring three types of reagents. Twenty of 109 patients had long levelof APTT by measuring Hemosil synhAsil-SS reagent and had normal level with Hemosil SynthAFox-SF and Hemosil APTT-SP. Seven of 109 patients had long level of APTT by measuring Hemosil synhAsil- SS reagent and Hemosil APTT-SP reagent and had normal level of APTT with Hemosil SynthAFox-SF. Twenty of 109 patients had long level of APTT by measuring Hemosil synhAsil- SS reagent and Hemosil SynthA Fox-SF reagent and had normal level of APTT with Hemosil APTT-SP.
Conclusion
Haemostasis is a complex physiological cascade which was began at the endothelium injury. Many kinds of complex prosedures occured after this injury. Beacuse of this complex cascade pathway, bleeding is not occured every kind of APTT level. Bleeding events usually occured at <%30 level of plasma factors but mild or moderate plasma factor levels can caused bleeing. Therefor sensitivite of APTT reagents are very important. Every kind of APTT reagent do not have equal sensitivite against plasma factor levels, phospholipid composition and concentration in thromboplastin reagent. Several studies suggested that range of APTT should be determinate according to the devices and reagents and also several studies comparied APTT reagents which was included silica, ellagic asid and phospholipids by composed of syntethic or animal orginated and several studies determined a target level of APTT for looking at the plasma factors levels. If we want to get a correct result of APTT, ranges of APTT must be determine according to reagents which was used in APTT devices and APTT reagents must be sensitive against borderlines cases who had a mild or moderate low levels of factors and the presence lupus antıcouglant. We need further studies to make a standardization and harmonization of APTT.
Session topic: 31. Other Non-malignant hematopoietic disorders
Keyword(s): Hemostasis, APTT, Standardization
