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Updated: Dec 27, 2025
Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
Evaluation of platelet count and platelet function analyzer - 100 testing for prediction of platelet transfusion
Dejana Bogdanić1, Nikolina Bogdanić2, Nenad Karanović3
1Department of Transfusion Medicine, University Hospital Center Split, Split, Croatia.
Insights
Collagen adenosine diphosphate closure time (cADP-CT) measured by Platelet Function Analyzer is a better predictor of further platelet (PLT) transfusions in cardiac surgery patients than PLT count. This finding aids in optimizing transfusion therapy post-coronary bypass grafting.
Area of Science:
- Cardiovascular Surgery
- Hematology
- Transfusion Medicine
Background:
- Platelet transfusions are critical for managing bleeding after cardiac surgery.
- Predicting the need for further platelet (PLT) transfusions is essential for patient care.
Purpose of the Study:
- To compare the predictive value of platelet count versus collagen adenosine diphosphate closure time (cADP-CT) for subsequent PLT transfusions in coronary artery bypass grafting (CABG) patients.
- To evaluate the efficacy of Platelet Function Analyzer (PFA) in guiding transfusion decisions.
Main Methods:
- Prospective observational study of 66 CABG patients receiving early PLT transfusions.
- Measurement of PLT count and cADP-CT at two time points: before and after PLT transfusion.
- Use of receiver operating characteristic (ROC) curves to assess predictive accuracy for further PLT transfusion within 48 hours postoperatively.
Main Results:
- cADP-CT after PLT transfusion demonstrated a higher positive predictive value (86%) for further transfusion compared to PLT count (33%).
- A cADP-CT threshold of ≥118 seconds and PLT count threshold of ≤200 × 109/L were identified.
- cADP-CT was the strongest predictor in multiple regression analysis for the number of PLT transfusion doses needed postoperatively.
Conclusions:
- cADP-CT measured by PFA offers superior predictive capacity for further PLT transfusions in CABG patients compared to PLT count.
- These findings suggest cADP-CT can improve the management and optimization of PLT transfusion strategies in cardiac surgery.
Abstract:
Platelet transfusions are commonly administered to treat bleeding in cardiac surgery. The aim of this study was to compare platelet (PLT) count and values of collagen adenosine diphosphate closure time (cADP-CT) measured by Platelet Function Analyzer (PFA) for prediction of PLT transfusion therapy following coronary bypass surgery. For this prospective observational study, 66 patients scheduled for coronary artery bypass grafting (CABG) who received early PLT transfusions (within 60 min after the operation) were enrolled. To assess changes in platelets, count and function, two time points were selected: 15 min before and 30 - 60 min after the end of PLT transfusion. The patients were divided into transfused and non-transfused with further PLT in the 48 h postoperatively. We used the receiver operating characteristics (ROC) curve to investigate whether the PLT count and cADP-CT values were predictors of PLT transfusion. The positive predictive values (PPV) of PLT count and cADP-CT after PLT transfusion for further PLT transfusion were 33% and 86% respectively, with a PLT count threshold of ≤200 × 109/L and cADP-CT threshold of ≥118 s. The comparison among the ROC curves showed a statistical difference (p = .0002). In multiple regression analysis, cADP-CT was the strongest predictor for the number of PLT transfusion doses in the 48 h postoperatively. In CABG patients, the results of cADP-CT after PLT transfusion have a better predictive capacity for further PLT transfusions than the PLT count.
