Acta clinica Belgica · 2025
Lupus anticoagulant testing in Belgian laboratories: a comparison with the 2020 International Society on Thrombosis and Haemostasis Scientific and Standardization Committee (ISTH-SSC) guidelines.
СтатьяСравнительное исследованиеОбзорНазвание и аннотация: Перевод в очереди
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Vanhove Benedicte, Van Hoovels Lieve, Broeders Sylvia, Coucke Wim, Schreurs Marco W J, Bonroy Carolien, Schouwers Sofie, Vanstokstraeten Robin, Bailleul Els, Devreese Katrien M J
Аннотация
OBJECTIVES: We investigated lupus anticoagulant (LA) testing in Belgium and verified these findings against the 2020 International Society on Thrombosis and Haemostasis Scientific and Standardization Committee (ISTH-SSC) Guidelines.
METHODS: A survey, interrogating pre- and post-analytical aspects of antiphospholipid antibodies, including LA analysis, was distributed to all Belgian laboratories (n = 111).
RESULTS: About 66% of the laboratories responding to the entire survey (58%) performed LA analysis. About 78% used thrombocyte-free citrated plasma. Most (90%) used the combination of dilute Russell's viper venom time (dRVVT) and activated partial thromboplastin time (aPTT), performing dRVVT (82%) and aPTT (78%) if the screening test was prolonged. A variety of instrument/reagent combinations were used. Normal pooled plasma (PNP) for mixing tests was used by 83%, either commercially lyophilized (56%) or frozen (44%), mostly (98%) in a 1:1 PNP: patient plasma ratio. Interpretation was based on normalized clotting time ratio, using manufacturers' or own study data as cutoff values. About 61% gave a final conclusion. About 88% added comments, mainly (94%) with a positive result. All laboratories programmed a barring period after an initial positive result. About 66% performed LA detection in patients receiving direct oral anticoagulants, 74% after using sample pretreatment with active charcoal absorption. LA testing for vitamin K antagonists and heparin-treated patients was done by 54%, regardless of international normalized ratio (64%) or anti-FXa results (82%).
CONCLUSIONS: The survey shows adherence to ISTH-SSC guidelines, especially for sample preparation and test methodologies. Additional efforts are required to harmonize LA detection in anticoagulated patients and result interpretation.
METHODS: A survey, interrogating pre- and post-analytical aspects of antiphospholipid antibodies, including LA analysis, was distributed to all Belgian laboratories (n = 111).
RESULTS: About 66% of the laboratories responding to the entire survey (58%) performed LA analysis. About 78% used thrombocyte-free citrated plasma. Most (90%) used the combination of dilute Russell's viper venom time (dRVVT) and activated partial thromboplastin time (aPTT), performing dRVVT (82%) and aPTT (78%) if the screening test was prolonged. A variety of instrument/reagent combinations were used. Normal pooled plasma (PNP) for mixing tests was used by 83%, either commercially lyophilized (56%) or frozen (44%), mostly (98%) in a 1:1 PNP: patient plasma ratio. Interpretation was based on normalized clotting time ratio, using manufacturers' or own study data as cutoff values. About 61% gave a final conclusion. About 88% added comments, mainly (94%) with a positive result. All laboratories programmed a barring period after an initial positive result. About 66% performed LA detection in patients receiving direct oral anticoagulants, 74% after using sample pretreatment with active charcoal absorption. LA testing for vitamin K antagonists and heparin-treated patients was done by 54%, regardless of international normalized ratio (64%) or anti-FXa results (82%).
CONCLUSIONS: The survey shows adherence to ISTH-SSC guidelines, especially for sample preparation and test methodologies. Additional efforts are required to harmonize LA detection in anticoagulated patients and result interpretation.