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Uncovering Hidden Traces of K2EDTA Contamination in Citrated Blood Samples: A Novel Approach Using Fibrinogen Clot
Ozben Ozden Isiklar1, Evin Kocaturk1, Kevser Setenay Oner1
1Eskişehir Osmangazi University, Eskişehir, Turkey.
International Journal of Laboratory Hematology
|June 30, 2025
Summary
K2EDTA contamination above 17% significantly impacts coagulation test results, affecting prothrombin time (PT) and activated partial thromboplastin time (aPTT). Clot waveform analysis effectively detects this contamination in blood samples.
Area of Science:
- Clinical Chemistry
- Hematology
- Laboratory Medicine
Background:
- Preanalytical errors significantly impact coagulation assay diagnostic accuracy.
- K2EDTA contamination is a critical preanalytical error affecting key coagulation tests like PT, aPTT, fibrinogen, and TT.
Purpose of the Study:
- To evaluate the impact of varying K2EDTA contamination levels on coagulation test results.
- To assess the efficacy of clot waveform analysis in identifying K2EDTA contamination in citrated blood.
Main Methods:
- Citrated whole blood samples from 36 healthy volunteers were spiked with K2EDTA at concentrations ranging from 5% to 100%.
- Coagulation assays (aPTT, PT, fibrinogen, TT) were performed on a Sysmex CN 6000 analyzer.
- Clot waveform analysis was employed to detect K2EDTA contamination.
Main Results:
- Significant alterations in aPTT were observed with K2EDTA contamination exceeding 17%.
- PT and fibrinogen assays showed significant deviations at 29% contamination.
- Thrombin time (TT) was significantly affected by 33% K2EDTA contamination.
- Fibrinogen second-derivative graphs demonstrated high sensitivity (80.3%) and specificity (99.3%) for detecting contamination (AUC=0.94).
Conclusions:
- K2EDTA contamination levels above 17% can lead to clinically significant inaccuracies in coagulation test results.
- Clot waveform analysis, specifically fibrinogen second-derivative analysis, is a reliable method for detecting K2EDTA contamination.
- Adherence to proper sample collection protocols is essential to prevent K2EDTA contamination and ensure accurate coagulation testing.
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