Detecting Heparin Contamination in Prolonged APTT with a Heparin-Resistant Solution

Area of Science:

• Clinical Chemistry
• Hematology
• Laboratory Medicine

Background:

• Activated partial thromboplastin time (APTT) is crucial for coagulation assessment.
• Prolonged APTT can stem from pathology or unfractionated heparin (UFH) contamination.
• Differentiating true pathology from heparin interference is vital for patient care.

Purpose of the Study:

• To evaluate the efficacy of Antihepca HRRS (AHCa), a Heparin Resistant Recalcifying Solution (HRRS), in neutralizing heparin interference in APTT assays.
• To assess AHC a's impact on APTT results in both heparinized and non-heparinized patient samples.
• To determine the neutralization limit of AHC a for UFH.

Main Methods:

• APTT testing was performed using AHC a HRRS and standard CaCl2 on Sysmex CN-6000 and Stago Start Max analyzers.
• Samples included 33 heparinized, 41 non-heparinized, and 30 random prolonged APTT patient plasmas.
• Heparin-spiked plasmas were used to establish the UFH neutralization limit of AHC a.

Main Results:

• AHCa HRRS corrected prolonged APTT in samples with UFH up to 0.6 IU/mL.
• In heparinized samples, AHC a reduced APTT to <40 s, simplifying reporting.
• AHCa corrected 8 of 30 prolonged APTT samples, indicating heparin, while 20 suggested other causes.

Conclusions:

• AHCa HRRS effectively neutralizes UFH interference in APTT testing.
• AHCa demonstrates minimal impact on APTT results in non-heparinized samples, preserving accuracy.
• AHCa offers a practical alternative for identifying heparin contamination in clinical labs.