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Overview of Hemostasis and Thrombosis and Contribution of Laboratory Testing to Diagnosis and Management of Hemostasis and Thrombosis Disorders

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Hemostasis and Thrombosis

Part of the book series: Methods in Molecular Biology ((MIMB,volume 1646))

Abstract

Hemostasis is a complex and tightly regulated process whereby the body attempts to maintain a homeostatic balance to permit normal blood flow, without bleeding or thrombosis. When this balance is disrupted, due to trauma or underlying congenital bleeding or thrombotic disorders, clinical intervention may be required. To assist clinicians in diagnosing and managing affected patients, hemostasis laboratories offer an arsenal of tests, both routine (screening) and more specialized (diagnostic). In general, screening assays are used to screen for hemostasis-related disease or to monitor or measure the effect of anticoagulant therapy, which may be applied to treat patients with recent thrombosis or at risk of thrombosis. Diagnostic assays are used to diagnose or exclude specific hemostasis-related diseases, and in some cases, to monitor or measure the effect of anticoagulant therapy, or alternatively procoagulant therapy that may be applied to those at risk of bleeding. This chapter provides an overview of hemostasis and thrombosis with respect to laboratory tests that may be applied to affected patients.

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References

  1. Lippi G, Favaloro EJ, Franchini M, Guidi GC (2009) Milestones and perspectives in coagulation and hemostasis. Semin Thromb Hemost 35:9–22

    Article  PubMed  Google Scholar 

  2. Lippi G, Franchini M, Favaloro EJ (2016) Diagnostics of inherited bleeding disorders of secondary haemostasis: an easy guide for routine clinical laboratories. Semin Thromb Hemost 42:471–477

    Article  PubMed  Google Scholar 

  3. Lippi G, Pasalic L, Favaloro EJ (2015) Detection of mild inherited disorders of blood coagulation: current options and personal recommendations. Expert Rev Hematol 8:527–542

    Article  CAS  PubMed  Google Scholar 

  4. Bonar RA, Favaloro EJ (2010) Quality in coagulation and haemostasis testing. Biochem Med 20:184–199

    Article  Google Scholar 

  5. Sadler JE, Budde U, Eikenboom JC, et al.; Working party on von Willebrand Disease Classification (2006) Update on the pathophysiology and classification of von Willebrand Disease: a report of the Subcommittee on von Willebrand Factor. J Thromb Haemost 4, 2103–2114

    Google Scholar 

  6. Blanchette VS, Srivastava A (2015) Definitions in hemophilia: resolved and unresolved issues. Semin Thromb Hemost 41:819–825

    Article  PubMed  Google Scholar 

  7. Favaloro EJ, Pasalic L, Curnow J (2016) Laboratory tests used to help diagnose von Willebrand disease: an update. Pathology 48:303–318

    Article  CAS  PubMed  Google Scholar 

  8. Favaloro EJ, Bodó I, Israels SJ, Brown SA (2014) von Willebrand disease and platelet disorders. Haemophilia 20(Suppl 4):59–64

    Article  CAS  PubMed  Google Scholar 

  9. Coppola A, Tufano A, Cerbone AM, Di Minno G (2009) Inherited thrombophilia: implications for prevention and treatment of venous thromboembolism. Semin Thromb Hemost 35:683–694

    Article  CAS  PubMed  Google Scholar 

  10. Favaloro EJ (2015) Anticoagulant therapy: present and future. Semin Thromb Hemost 41:109–112

    Article  PubMed  Google Scholar 

  11. Favaloro EJ, Lippi G (2015) Laboratory testing in the era of direct or non-vitamin k antagonist oral anticoagulants: a practical guide to measuring their activity and avoiding diagnostic errors. Semin Thromb Hemost 41:208–227

    Article  CAS  PubMed  Google Scholar 

  12. Favaloro EJ, Lippi G (2017) Interference of direct oral anticoagulants (DOACs) in hemostasis assays: high potential for diagnostic false positives and false negatives. Blood Transfus 7:1–4

    Google Scholar 

  13. Favaloro EJ, Lippi G, Adcock DM (2008) Preanalytical and postanalytical variables: the leading causes of diagnostic error in haemostasis. Semin Thromb Hemost 34:612–634

    Article  CAS  PubMed  Google Scholar 

  14. Adcock DM, Favaloro EJ, Lippi G (2016) Critical pre-examination variables in the hemostasis laboratory and their quality indicators. Critical pre-examination variables in the hemostasis laboratory and their quality indicators. Clin Biochem 49:1315–1320

    Article  PubMed  Google Scholar 

  15. Favaloro EJ, Lippi G (2010) Laboratory reporting of hemostasis assays: the final post-analytical opportunity to reduce errors of clinical diagnosis in hemostasis? Clin Chem Lab Med 48:309–321

    CAS  PubMed  Google Scholar 

  16. Lippi G, Franchini M, Guidi GC (2007) Diagnostic approach to inherited bleeding disorders. Clin Chem Lab Med 45:2–12

    CAS  PubMed  Google Scholar 

  17. Yee A, Kretz CA (2014) Von Willebrand Factor: form for function. Semin Thromb Hemost 40:17–27

    CAS  PubMed  Google Scholar 

  18. Kwaan H, Lisman T, Medcalf RL (2017) Fibrinolysis: biochemistry, clinical aspects, and therapeutic potential. Semin Thromb Hemost 43(2):113–114

    Article  PubMed  Google Scholar 

  19. Hoffman M (2003) A cell-based model of coagulation and the role of factor VIIa. Blood Rev 17:51–55

    Article  Google Scholar 

  20. Quick AJ (1935) The prothrombin time in haemophilia and in obstructive jaundice. J Biol Chem 109:73–74

    Google Scholar 

  21. Favaloro EJ, Adcock DM (2008) Standardisation of the INR: how good is your laboratory’s INR and can it be improved. Semin Thromb Hemost 34:593–603

    Article  PubMed  Google Scholar 

  22. Bonar R, Mohammed S, Favaloro EJ (2015) International normalized ratio monitoring of vitamin K antagonist therapy: comparative performance of point-of-care and laboratory-derived testing. Semin Thromb Hemost 41:279–286

    Article  CAS  PubMed  Google Scholar 

  23. Kitchen DP, Jennings I, Kitchen S, Woods TA, Walker ID (2015) Bridging the gap between point-of-care testing and laboratory testing in hemostasis. Semin Thromb Hemost 41:272–278

    Article  PubMed  Google Scholar 

  24. Bonar R, Favaloro EJ (2017) Explaining and reducing the variation in inter-laboratory reported values for International Normalised Ratio. Thromb Res 150:22–29

    Article  CAS  PubMed  Google Scholar 

  25. Lippi G, Favaloro EJ (2008) Activated partial thromboplastin time: new tricks for an old dogma. Semin Thromb Hemost 34:604–611

    Article  CAS  PubMed  Google Scholar 

  26. Pengo V, Tripodi A, Reber G et al (2009) Update of the guidelines for lupus anticoagulant detection. J Thromb Haemost 7:1737–1740

    Article  CAS  PubMed  Google Scholar 

  27. Jennings I, Kitchen S, Kitchen DP, Woods TAL, Walker ID (2011) ISTH/SSC lupus anticoagulant testing guidelines: how far have these been adopted by laboratories? J Thromb Haemost 9:2117–2179

    Article  CAS  PubMed  Google Scholar 

  28. Penmetsa GK, Rodgers GM, Smock KJ (2010) Avoiding errors in the laboratory evaluation of potent lupus anticoagulants. Am J Hematol 85:272–274

    Article  PubMed  Google Scholar 

  29. Undas A (2016) How to assess fibrinogen levels and fibrin clot properties in clinical practice? Semin Thromb Hemost 42:381–388

    Article  CAS  PubMed  Google Scholar 

  30. Muszbek L, Katona É (2016) Diagnosis and management of congenital and acquired FXIII deficiencies. Semin Thromb Hemost 42:429–439

    Article  PubMed  Google Scholar 

  31. Lippi G, Danese E, Favaloro EJ, Montagnana M, Franchini M (2015) Diagnostics in venous thromboembolism: from origin to future prospects. Semin Thromb Hemost 41:374–381

    Article  PubMed  Google Scholar 

  32. Favaloro EJ, Bonar R, Sioufi J, Wheeler M, Low J, Aboud M, Duncan E, Smith J, Exner T, Lloyd J, Marsden K (2005) Multi-laboratory testing of thrombophilia: current and past practice in Austrasia as assessed through the Royal College of Pathologist of Australasia quality Assurance Program for Hematology. Semin Thromb Hemost 31:49–58

    Article  PubMed  Google Scholar 

  33. Favaloro EJ, Wong RCW (2014) Antiphospholipid antibody testing for the antiphospholipid syndrome: a synopsis of challenges and recent guidelines. Pathology 46:481–495

    Article  CAS  PubMed  Google Scholar 

  34. Galli M, Luciani D, Bertolini G, Barbui T (2003) Lupus anticoagulants are stronger risk factors for thrombosis than anticardiolipin antibodies in the antiphospholipid syndrome: a systematic review of the literature. Blood 101:1827–1832

    Article  CAS  PubMed  Google Scholar 

  35. Moore GW (2014) Recent guidelines and recommendations for laboratory detection of lupus anticoagulants. Semin Thromb Hemost 40:163–171

    Article  CAS  PubMed  Google Scholar 

  36. Favaloro EJ, Bonar RA, Marsden K (2012) Internal quality control and external quality assurance in testing for antiphospholipid antibodies: part II-lupus anticoagulant. Semin Thromb Hemost 38:404–411

    Article  CAS  PubMed  Google Scholar 

  37. Bonar R, Favaloro E, Zebeljan D et al (2012) Evaluating laboratory approaches to the identification of lupus anticoagulants: a diagnostic challenge from the RCPA Haematology QAP. Pathology 44:240–247

    Article  PubMed  Google Scholar 

  38. Favaloro EJ, Lippi G, Koutts J (2011) Laboratory testing of anticoagulant: the present and future. Pathology 43:682–692

    Article  CAS  PubMed  Google Scholar 

  39. Lippi G, Favaloro EJ (2015) Recent guidelines and recommendations for laboratory assessment of the direct oral anticoagulants (DOACs): is there consensus? Clin Chem Lab Med 53:185–197

    CAS  PubMed  Google Scholar 

  40. Cuker A (2012) Unfractionated heparin for the treatment of venous thromboembolism: best practices and areas of uncertainty. Semin Thromb Hemost 38:593–599

    Article  CAS  PubMed  Google Scholar 

  41. Warkentin TE (2015) Heparin-induced thrombocytopenia in critically ill patients. Semin Thromb Hemost 41:49–60

    Article  CAS  PubMed  Google Scholar 

  42. Cuker A (2014) Clinical and laboratory diagnosis of heparin-induced thrombocytopenia: an integrated approach. Semin Thromb Hemost 40:106–114

    CAS  PubMed  Google Scholar 

  43. Bonar R, Favaloro EJ, Marsden K (2012) External quality assurance in heparin monitoring. Semin Thromb Hemost 38:632–639

    Article  CAS  PubMed  Google Scholar 

  44. Bonar R, Favaloro EJ, Mohammed S, Pasalic L, Sioufi J, Marsden K (2015) The effect of dabigatran on haemostasis tests: a comprehensive assessment using in-vitro and ex-vivo samples. Pathology 47:355–364

    Article  PubMed  Google Scholar 

  45. Bonar R, Favaloro EJ, Mohammed S, Ahuja M, Pasalic L, Sioufi J, Marsden K (2016) The effect of the direct factor Xa inhibitors apixaban and rivaroxaban on haemostasis tests: a comprehensive assessment using in vitro and ex vivo samples. Pathology 48:60–71

    Google Scholar 

  46. Favaloro EJ, Bonar RA, Meiring M, Duncan E, Mohammed S, Sioufi J, Marsden K (2014) Evaluating errors in the laboratory identification of von Willebrand disease in the real world. Thromb Res 134:393–403

    Article  CAS  PubMed  Google Scholar 

  47. Favaloro EJ, Bonar RA, Mohammed S, Arbelaez A, Niemann F, Freney R, Meiring M, Sioufi J, Marsden K (2016) Type 2M von Willebrand disease – more often misidentified than correctly identified. Haemophilia 22:e145–e155

    Google Scholar 

  48. Favaloro EJ (2017) Utility of the von Willebrand factor collagen binding assay in the diagnosis of von Willebrand disease. Am J Hematol 92:114–118

    Article  CAS  PubMed  Google Scholar 

  49. Favaloro EJ, Pasalic L, Curnow J (2016) Type 2M and Type 2A von Willebrand Disease: similar but different. Semin Thromb Hemost 42:483–497

    Article  CAS  PubMed  Google Scholar 

  50. Franchini M, Lippi G, Veneri D, Targher G, Zaffanello M, Guidi GC (2008) Inherited platelet disorders. Clin Chim Acta 387:1–8

    Article  CAS  PubMed  Google Scholar 

  51. Favaloro EJ (2016) Clinical utility of closure times using the Platelet Function Analyzer (PFA)-100/200. Am J Hematol. doi:10.1002/ajh.24620

    PubMed  Google Scholar 

  52. Favaloro EJ (2008) Clinical utility of the PFA-100. Semin Thromb Hemost 34:709–733

    Article  CAS  PubMed  Google Scholar 

  53. Favaloro EJ, Lippi G, Franchini M (2010) Contemporary platelet function testing. Clin Chem Lab Med 48:579–598

    CAS  PubMed  Google Scholar 

  54. Lordkipanidzé M (2016) Platelet function tests. Semin Thromb Hemost 42:258–267

    Article  PubMed  Google Scholar 

  55. Blanchette VS, Key NS, Ljung LR, Manco-Johnson MJ, van den Berg HM, Srivastava A, Subcommittee on Factor VIII, Factor IX and Rare Coagulation Disorders of the Scientific and Standardization Committee of the International Society on Thrombosis and Hemostasis (2014) Definitions in hemophilia: communication from the SSC of the ISTH. J Thromb Haemost 12:1935–1939

    Article  CAS  PubMed  Google Scholar 

  56. Favaloro EJ, Verbruggen B, Miller CH (2014) Laboratory testing for factor inhibitors. Haemophilia 20(Suppl 4):94–98

    Article  PubMed  Google Scholar 

  57. Bonar RA, Favaloro EJ, Marsden K (2013) External quality assessment of factor VIII inhibitor assays. Semin Thromb Hemost 39:320–326

    Article  PubMed  Google Scholar 

  58. Adcock DM, Favaloro EJ (2015) Pearls and pitfalls in factor inhibitor assays. Int J Lab Hematol 37(Suppl 1):52–60

    Article  PubMed  Google Scholar 

  59. Favaloro EJ, Meijer P, Jennings I, Sioufi J, Bonar RA, Kitchen DP, Kershaw G, Lippi G (2013) Problems and solutions in laboratory testing for hemophilia. Semin Thromb Hemost 39:816–833

    Article  PubMed  Google Scholar 

  60. Peyvandi F, Favaloro EJ (2009) Rare bleeding disorders. Semin Thromb Hemost 35:345–347

    Article  PubMed  Google Scholar 

  61. Kershaw G, Suresh S, Prellana D, Nguy Y (2012) Laboratory identification of lupus anticoagulants. Semin Thromb Hemost 38:375–384

    Article  CAS  PubMed  Google Scholar 

  62. Plebani M, Sanzari MC, Zardo L (2008) Quality control in coagulation testing. Semin Thromb Hemost 34:642–646

    Article  PubMed  Google Scholar 

  63. Clinical and Laboratory Standards Institute (CLSI) (2008) Collection, transport and processing of blood specimens for testing plasma-based coagulation assays and molecular haemostasis assays; approved guideline. vol 28, no. 5: CLSI document H21-A5

    Google Scholar 

  64. Lippi G, Salvagno GL, Montagnana M, Lima-Oliveira G, Guidi GC, Favaloro EJ (2012) Quality standards for sample collection in coagulation testing. Semin Thromb Hemost 38:565–575

    Article  PubMed  Google Scholar 

  65. Adcock Funk DM, Lippi G, Favaloro EJ (2012) Quality standards for sample processing, transportation, and storage in hemostasis testing. Semin Thromb Hemost 38:576–585

    Article  CAS  PubMed  Google Scholar 

  66. Lippi G, Plebani M, Favaloro EJ (2013) Interference in coagulation testing: focus on spurious hemolysis, icterus, and lipemia. Semin Thromb Hemost 39:258–266

    Article  PubMed  Google Scholar 

  67. Favaloro EJ, McVicker W, Lay M, Ahuja M, Zhang Y, Hamdam S, Hocker N (2016) Harmonizing the International Normalized Ratio (INR): standardization of methodologies and use of novel strategies to reduce inter-laboratory variation and bias. Am J Clin Pathol 145:191–202

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Royal College of Pathologists of Australasia Quality Assurance Program (RCPAQAP) Haematology, Suite 201, Level 2, 8 Herbert Street, St Leonards, NSW, Australia

    Roslyn A. Bonar

  2. Section of Clinical Biochemistry, University of Verona, Verona, Italy

    Giuseppe Lippi

  3. Haematology Department, Sydney Centres for Thrombosis and Haemostasis, Institute of Clinical Pathology and Medical Research (ICPMR), Westmead Hospital, NSW Health Pathology, Westmead, NSW, 2145, Australia

    Emmanuel J. Favaloro

Authors
  1. Roslyn A. Bonar
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  2. Giuseppe Lippi
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  3. Emmanuel J. Favaloro
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Corresponding author

Correspondence to Roslyn A. Bonar .

Editor information

Editors and Affiliations

  1. Department of Haematology, Sydney Centres for Thrombosis and Haemostasis, Institute of Clinical Pathology and Medical Research (ICPMR), NSW Health Pathology, Westmead Hospital, Westmead, New South Wales, Australia

    Emmanuel J. Favaloro

  2. Section of Clinical Biochemistry, University of Verona, Verona, Italy

    Giuseppe Lippi

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Bonar, R.A., Lippi, G., Favaloro, E.J. (2017). Overview of Hemostasis and Thrombosis and Contribution of Laboratory Testing to Diagnosis and Management of Hemostasis and Thrombosis Disorders. In: Favaloro, E., Lippi, G. (eds) Hemostasis and Thrombosis. Methods in Molecular Biology, vol 1646. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-7196-1_1

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  • DOI: https://doi.org/10.1007/978-1-4939-7196-1_1

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  • Publisher Name: Humana Press, New York, NY

  • Print ISBN: 978-1-4939-7194-7

  • Online ISBN: 978-1-4939-7196-1

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