International Council for Standardization in Haematology (ICSH) recommendations for processing of blood samples for coagulation testing.

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 Dear friends, 

Sorry, I could not post anything in the last 8 months.

 Hoping to write regularly henceforth. 

Thank you all for your support and wishes. 

International Council for Standardization in Haematology (ICSH) establishes guidelines on various hematology laboratory tests and diseases to help the hematology community in having universal standards of laboratory tests and reporting. The ICSH recommendations for processing of coagulation testing has been published in August 2021. The article is freely downloadable from the website. 

I have summed up the recommendations in this post and will continue the remaining in the next post. 

Storage: 

Recommendation 1: Whole blood samples for coagulation tests should be maintained at an ambient temperature of 18-24°C during transport and storage prior to processing.

Pneumatic tube transport systems 

Recommendation 2: Pneumatic tube transport systems should not be used to transport citrated blood samples prior to tests of platelet function.

Recommendation 3: Each laboratory should assess the impact of transport of citrated blood samples through their pneumatic tube system for clotting screening tests prior to any routine use of such systems.

Clots in citrated blood samples 

Recommendation 4: Any citrated blood samples, for coagulation tests, should be rejected if clots of any size are detected.

Recommendation 5: Citrated samples with APTT results 4 or more seconds below the lower limit of reference range should be scrutinized for possible presence of clots.

Centrifugation 

Recommendation 6: Citrated blood samples for coagulation testing should be centrifuged at an ambient temperature of 18-24°C using conditions sufficient to achieve platelet-poor plasma with a residual platelet count of <10 × 109/L.

Remark: This can normally be achieved by centrifugation for 15 minutes at 1500 g or 10 minutes at 1700 g and should be checked by performing platelet counts on platelet-poor plasma every 6-12 months.

Recommendation 7: Samples destined for lupus anticoagulant testing and samples containing UFH destined for APTT or anti-Xa testing should be subjected to a second centrifugation process after the first, prior to being frozen.

Primary Tube storage and stability 

Recommendation 8: The allowed interval between sample collection and testing should be validated or verified for blood collection tube and specific coagulation laboratory tests and methods in use.

Recommendation 9: Citrated blood samples containing unfractionated heparin destined for APTT or anti-Xa determination should be centrifuged within 1 hour of collection, and the analysis shall be completed within 4 hours of collection.

The remaining recommendations will be discussed in the next post. 

Reference: 

Kitchen S, M.Adcock D, Dauers R, Kristoffersen A-H, Lippi G, Mackier I, Marlar RA, Nair S. International Council for Standardization in Haematology (ICSH) recommendations for processing of blood samples for coagulation testing. Int J Lab Hematol. 2021;43:1272–83.

                                                                                       Dr.Priyavadhana

                                                                                   


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