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The Platelet Function Analyzer (PFA-100): a novel in-vitro system for evaluation of primary haemostasis in children
M D Carcao1, V S Blanchette, J A Dean
1Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada.
Insights
The PFA-100 system measures platelet function via closure time (CT). Neonates show shorter CTs than children and adults, suggesting potential for diagnosing von Willebrand disease in pediatric patients.
Area of Science:
- Hematology
- Pediatric Medicine
- Diagnostic Assays
Background:
- Primary hemostasis assessment is crucial for diagnosing bleeding disorders.
- The PFA-100 system offers an in-vitro method to evaluate platelet function.
- Establishing age-specific reference ranges is essential for accurate interpretation of diagnostic tests.
Purpose of the Study:
- To establish normal closure time (CT) ranges using the PFA-100 system in healthy children, adults, and neonates.
- To assess the PFA-100 system's utility in pediatric populations, including those with hemophilia.
- To evaluate the potential of the PFA-100 system for screening pediatric von Willebrand disease.
Main Methods:
- Utilized the PFA-100 system for in-vitro assessment of platelet function.
- Measured closure time (CT) in healthy neonates, children, and adults.
- Analyzed CTs in relation to age and needle gauge (21G, 23G) for blood collection.
- Included children with hemophilia in the study cohort.
Main Results:
- Mean CTs in healthy children were similar to adults and independent of needle gauge.
- Mean CTs in healthy neonates were significantly shorter than in children and adults.
- Children with hemophilia exhibited normal CTs on the PFA-100 system.
- The PFA-100 system demonstrated potential utility in screening for von Willebrand disease in children.
Conclusions:
- Normal PFA-100 CT ranges vary with age, with neonates having distinct values.
- The PFA-100 system may not be sensitive for detecting hemophilia in children.
- The PFA-100 system shows promise as a screening tool for von Willebrand disease in pediatric patients.
Abstract:
The PFA-100 system provides an in-vitro method of assessing primary platelet-related haemostasis by measuring the time (the closure time, or CT) taken for a platelet plug to occlude a microscopic aperture cut into a membrane coated with collagen and either epinephrine or ADP. We used the system to establish normal ranges for CTs in healthy children, adults and neonates. Mean CTs of healthy children were independent of the needle gauge used (21G or 23CG) for blood sampling; they were very similar to the mean CTs of healthy adults, but longer than mean CTs of healthy neonates. Although children with haemophilia had normal CTs, the PFA-100 system was found to be potentially useful in screening for von Willebrand disease in children.