Optimizing centrifugation of coagulation samples in laboratory automation

Area of Science:

• Clinical Chemistry
• Hematology
• Laboratory Automation

Background:

• High acceleration centrifugation is used in lab automation to speed up clinical chemistry but not coagulation testing.
• Current guidelines recommend low platelet counts for coagulation assays, often necessitating separate sample handling.
• Integrating coagulation sample processing into automation workflows can improve efficiency.

Purpose of the Study:

• To evaluate high acceleration centrifugation for coagulation sample processing.
• To determine if a single or double centrifugation run is sufficient for various coagulation assays.
• To assess the impact on platelet counts and assay performance.

Main Methods:

• Coagulation samples were subjected to high acceleration centrifugation (3280×g for 5 min) in one or two runs.
• Platelet counts and results for PT, APTT, factor VIII, and protein S were analyzed after each centrifugation step.
• Passing-Bablok regression was used to compare assay performance.

Main Results:

• All samples achieved platelet counts below 200×10(9)/L after one centrifugation.
• Second centrifugation reduced platelet counts below 10×10(9)/L in 73% of samples.
• PT, APTT, and F. VIII showed consistent performance after one or two centrifugations, but protein S required two centrifugations.

Conclusions:

• High acceleration centrifugation can integrate coagulation samples into laboratory automation systems.
• A single centrifugation is adequate for PT, APTT, and F. VIII assays.
• Two successive centrifugations are necessary for reliable protein S activity measurement.