EVALUATION OF A RAPID CENTRIFUGATION PROTOCOL FOR ROUTINE COAGULATION TESTING AT THE DEPARTMENT OF HEMATOLOGY AND TRANSFUSION MEDICINE, HANOI MEDICAL UNIVERSITY HOSPITAL
Main Article Content
Abstract
Objective: To identify an appropriate rapid centrifugation condition for the preparation of platelet-poor plasma (PPP) and to evaluate the analytical agreement of routine coagulation assays between a rapid centrifugation protocol and a conventional centrifugation protocol.
Methods: This experimental study was conducted at the Department of Hematology and Transfusion Medicine, Hanoi Medical University Hospital. In Phase 1, five centrifugation conditions were evaluated to identify a protocol capable of producing platelet-poor plasma meeting the recommended criterion of residual platelet count <10 × 10⁹/L. In Phase 2, analytical agreement between the selected rapid centrifugation protocol and the conventional protocol (1500g for 15 minutes) was assessed using 50 paired patient samples according to CLSI EP09c, applying Passing–Bablok regression, Bland–Altman analysis, and bias estimation at predefined medical decision levels.
Main findings: Centrifugation at 2500g for 10 minutes and 2500g for 7 minutes achieved the PPP criterion in 100% of samples; the 2500g for 7 minutes protocol was selected because of its shorter centrifugation time. PT-INR, APTT-ratio, and Fibrinogen showed a high degree of agreement between the rapid and conventional centrifugation protocols. Bias estimates at medical decision levels were within allowable limits, and all evaluated parameters achieved acceptable agreement according to CLSI EP09c.
Conclusions: The centrifugation protocol of 2500g for 7 minutes produced platelet-poor plasma meeting recommended quality criteria and yielded PT-INR, APTT-ratio, and Fibrinogen results comparable to those obtained using the conventional centrifugation protocol. The 2500g for 7 minutes centrifugation protocol can be implemented in routine coagulation testing practice.
Keywords
Rapid centrifugation, platelet-poor plasma, routine coagulation assays, CLSI EP09c, method comparison
Article Details
References
2. Clinical and Laboratory Standards Institute. Collection, Transport, and Processing of Blood Specimens for Testing Plasma-Based Coagulation Assays and Molecular Hemostasis Assays; Approved Guideline-Fifth Edition. CLSI guideline H21-A5. Wayne (PA): Clinical and Laboratory Standards Institute; 2008.
3. Magnette A, Chatelain M, Chatelain B, Ten Cate H, Mullier F. Pre-analytical issues in the haemostasis laboratory: guidance for the clinical laboratories. Thromb J. 2016; 14:49.
4. Nguyễn Thu Hạnh, Hà Văn Phú, Trần Thị Hằng, Đoàn An Sơn, Nguyễn Văn Chỉnh, Nguyễn Mạnh Cường, Nguyễn Mỹ Vân. So sánh tương đồng kết quả một số xét nghiệm đông máu (PT, APTT, Fibrinogen) giữa phương pháp ly tâm nhanh và ly tâm thường quy tại Khoa Huyết học, Bệnh viện Hữu nghị Việt Đức. Tạp chí Y học Cộng đồng. 2025;66(Số chuyên đề 1):37-44.
5. Haripersadh R, Pillay D, Rapiti N. Impact of rapid centrifugation on routine coagulation assays in South Africa. Afr J Lab Med. 2022;11(1).
6. Wolfensberger N, Georgiou G, Giabbani E, Reusser M, Njue LM, Fiedler M, Leichtle AB, Nagler M. Rapid centrifugation in the routine hemostasis laboratory. Thromb Haemost. 2019;119(12):2025-2033.
7. Quirke W, Koohestani Z. Revisiting coagulation centrifugation protocol for integration into total laboratory automation workflow. J Lab Precis Med. 2020; 5:13.
8. Clinical and Laboratory Standards Institute. Measurement Procedure Comparison and Bias Estimation Using Patient Samples. 3rd ed. CLSI guideline EP09c. Wayne (PA): Clinical and Laboratory Standards Institute; 2018.
9. Bộ Y tế. Hướng dẫn chẩn đoán và điều trị một số bệnh lý huyết học. Ban hành kèm theo Quyết định số 1832/QĐ-BYT ngày 01 tháng 7 năm 2022. Hà Nội: Bộ Y tế; 2022.
10. European Federation of Clinical Chemistry and Laboratory Medicine (EFLM). Biological Variation Database [Internet]. Milan: EFLM [cited 2026 Jun 02]. Available from: https://biologicalvariation.eu