Diagnostics
Thromboelastographic Assessment of the Differential Sensitivity of Three Contact Activators to Coagulation Factor Deficiencies in Hemocell Environments
By Weiguo Liang, Mao Xia, Junpo Li and 3 others.
Abstract
Background
Thromboelastography (TEG) assesses global coagulation, but its sensitivity for factor deficiencies is reportedly low and may depend on the contact activator. However, the differential TEG sensitivity of contact activators for individual factor deficiencies in whole blood containing platelets and red blood cells remains unclear. This study assessed the relative sensitivity of three contact activators for detecting single coagulation factor deficiencies in reconstituted whole-blood samples using TEG.
Methods
Reconstituted whole-blood samples with graded activities of FII, FV, FVIII, FIX, FX, FXI, and FXII were prepared by mixing platelets, plasma, and red blood cells, and analyzed by TEG using kaolin-, ellagic acid-, and colloidal silica-based activators (KL, EA and CS). Relative sensitivity was assessed via: (1) the factor activity at which R time first showed a statistically significant prolongation; (2) a novel metric, Sensitivity for Detecting Factor Deficiencies (SDFD), defined as the normalized relative change in R time, enabling comparison without reference ranges.