Platelet Aggregation on CS-2500 - Home - English - … · 2016-09-26 · automatic formatting step...
Transcript of Platelet Aggregation on CS-2500 - Home - English - … · 2016-09-26 · automatic formatting step...
LD HH | F. Richir
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User Day Hemostasis 2016
Platelet Aggregation on CS-2500
With the collaboration
of Hyphen
François Richir September 2016
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Hemostasis System Portfolio
Throughput
Sysmex® CA-660
64 TP/h
Sysmex® CS-2100i
180 TP/h
Sysmex® CS-5100
400 TP/h
Recent Instruments portfolio <4
years
INNOVANCE® PFA
BCS® XP
Sysmex® CS-2500
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The use of Platelet Aggregation?
Exploration of primary hemostasis: • Thrombopathies (Glanzmann Thrombastenia, Bernard Soulier…)
• Von Willebrand disease
• Antiplatelets drugs follow up: Aspirine (Gold Standard), anti-P2Y12 (Clopidogrel,
Prasugrel…)
• Heparin Induced Thrombocytopenia (HIT)
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The use of Platelet Aggregation?
University and central
hospital labs,
specialty labs, research labs
Antiplatelet
drug-therapy
management
Bleeding risk
management
Thrombophilia
and risk
factors
Standard
platelet
functionality
tests
Uncertain
Positive
Negative
Platelet
aggregation
testing
MULTIPLATE
CHRONOLOG HELENA
AGG RAM
VERIFYNOW
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The use of Platelet Aggregation?
• For one patient, we need 1 tube PPP & 1 tube PRP
• Platelet agonistes : (ADP, ristocétine…) at ≠ concentration
• Gradually increasing response helps for the interpretation
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No confusion with …
PFA • Closing time in seconds
• Replaces bleeding time
• Allows quick and easy screening
• 1st line test
Platelets Aggregation • Detailed platelet function
• Provides several advanced settings (max aggregation ,
AUC ... )
• Allows further detailed analysis
• 2nd line tests
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Decisional tree proposed
Syndrome hémorragique clinique
PFA (Cartouches ADP & EPI)
TCA NFS-Plaquettes
TO ADP N
TO EPI N
TO ADP N
TO EPI ↑↑
TO ADP ↑↑
TO EPI N ou ↑↑
TO ADP ↑↑
TO EPI ↑↑
Agrégation
Plaquettaire
Agrégation
Plaquettaire Dosages VWF
Agrégation
Plaquettaire Thrombopathie sécrétoire
Thrombopathie modérée
Aspirine et AINS Maladie de
Willebrand
Thrombopathie
Agrégation
Plaquettaire
Dosages VWF ↑
N
Pr Dine – CH Troyes – Siemens 2012
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Automatisation of platelet aggregation testing
Sysmex CS-2500 System
Man
ual
tim
e
Blood
sampling
Prepare (centrifuge
sample) Platelet-poor and platelet-rich plasma
Set stir-bar in sample cuvette
Au
tom
ated
tim
e Detection Results
Dispense PPP and PRP to sample cuvette
Add agonist to cuvette
Reduce steps, effort,
and complexity
*Sysmex CE-marked application.
Load the CB cuvettes
Automatic results produce clear aggregation reaction curves
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Automatisation of platelet aggregation testing
*Sysmex CE-marked application.
Automatic results produce clear aggregation reaction curves
Automatic results produce clear aggregation reaction curves
Normal
Glanzmann
Thrombasthenia
VWD
VWD Type 2B
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5 Agonists
ADP Epinephrin Collagen Arachidonic Acid Ristocetin
Exploration of Platelet secretion, P2Y12 Platelet adhesion
Platelet secretion and transformation,
aspirine
VWF and platelet aggregation
Kit content 0.625 mL x3 0.625 mL x3 0.625 mL x3 Dil:12 mL x3 0.625 mL x3 0.625 mL x3
Concentration 160 mM 0.8 mM 0.8 mg/mL 12 mM 12 mg/mL
Final Concentration 2 µmol/L 5 µmol/L 2 µgram/ml 1 mmol/L 1.2 mg/mL
Expiration date 12 m 12 m 12 m 18 m 30 m
Stability after
reconst.
2-8° 28 d 7 d 28 d 7 d 7 d
18-25° 24 h 24 h 24 h 24 h 8 h
-20° 2 m 2 m - 2 m 2 m
« Revohem » reagents From Hyphen / Distribution channel TBC
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Reagent management
40 reagents positions
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Cuvettes Management
24 (CS-2) to 40 (CS-5) cuvettes
Same cuvette than for
BC vW test (SB
cuvettes ref. 1041-9)
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Plasma management PPP & PRP (140 µL)
PRP
Patient 1
PPP
Patient 2
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Aggregation curve
Abs_PPP (mDO): PPP mDO
Abs_PRP (mDO): PRP mDO
Agg Max (%): Max Aggregation %
Fin (%): End point Aggregation %
Lag Phase Time (s):
Time from agoniste addition and aggregation start
AUC (%*S): Area under the aggregation curve
Vmax (%/s): Max velocity
VMax Time (S): Time for max velocity
Angle of Vmax: Vmax angle
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Curve superposition and smoothing
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Results exportation
Result exportation under .CSV format, impression, traceability
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First studies showing excellent results
Poster/Article
• Automation of Light Transmission Platelet Aggregation, University College London
• Precision and throughput of light transmission aggregometery on a routine coagulation analyser, University College London
• The Automation of Routine Light Transmission Platelet Aggregation on Sysmex CS-2000, ISTH 2015
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First studies showing excellent results
Lawrie & al. , The automation of routine light transmission platelet aggregation, International Journal of Laboratory
Hematology, October 2013
Patel & al. , Precision and throughput of light transmission aggregometery on a routine coagulation analyser,
September 2015
Need of 38% plasma less (140µL PRP vs 225µL)
Comparable curves profiles for 5 agonistes
Excellent CVs (1,6 < CV < 5,3%)
Time saving (28 min for 30 results on CS-5100)
Patel & al. , Precision and throughput of light transmission aggregometery on a routine coagulation analyser,
September 2015
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Thank you for your attention! Questions?