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Routine Screening Method for Microparticles in Platelet Transfusions
09:49

Routine Screening Method for Microparticles in Platelet Transfusions

Published on: January 31, 2018

Discard tubes are not necessary when drawing samples for specialized coagulation testing.

Kristi J Smock1, Ronda A Crist, Sarah J Hansen

  • 1Department of Pathology, University of Utah Health Sciences Center, Salt Lake City, Utah, USA. kristi.smock@aruplab.com

Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis
|February 26, 2010
PubMed
Summary

Discard tubes are not necessary for specialized coagulation testing. This study found no significant differences between the first and second tubes drawn, supporting the elimination of discard tubes for accurate results.

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Area of Science:

  • Clinical Pathology
  • Hematology
  • Laboratory Medicine

Background:

  • Traditionally, discard tubes are used in blood collection for coagulation tests to prevent inaccurate results from tissue factor activation.
  • While no longer required for prothrombin time and partial thromboplastin time, discard tubes are still recommended for specialized coagulation assays due to insufficient evidence.
  • This practice adds time and cost to blood collection procedures.

Purpose of the Study:

  • To determine if the initial citrate tube drawn is suitable for specialized coagulation testing.
  • To evaluate the necessity of discard tubes in obtaining accurate results for various coagulation assays.
  • To provide evidence-based recommendations for phlebotomy practices in coagulation testing.

Main Methods:

  • Testing included fibrinogen, D-dimer, factors VIII, IX, XI, proteins C and S, antithrombin, and factors II, VII, IX, X.
  • Samples were collected from healthy individuals and patients on warfarin.
  • Paired t-testing and agreement analysis (within 10% difference) were used to compare results from the first and second tubes.

Main Results:

  • No statistically significant differences were observed between the first and second tubes for any tested coagulation parameters.
  • The majority of data pairs showed agreement within 10% or less.
  • No positive or negative biases were detected between the two sample collection methods.

Conclusions:

  • Discard tubes are not necessary for specialized coagulation testing.
  • The first citrate tube can be reliably used for a wide range of coagulation assays, including those in normal and warfarinized populations.
  • Eliminating discard tubes can streamline laboratory workflows and reduce costs without compromising diagnostic accuracy.