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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter


IMPACT FACTOR 2018: 3.638

CiteScore 2018: 2.44

SCImago Journal Rank (SJR) 2018: 1.191
Source Normalized Impact per Paper (SNIP) 2018: 1.205

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1437-4331
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Volume 57, Issue 4

Issues

Next-generation rapid serum tube technology using prothrombin activator coagulant: fast, high-quality serum from normal samples

Kong-Nan Zhao
  • Centre for Venomics Research, School of Medicine, The University of Queensland, Translational Research Institute, Woolloongabba, QLD, Australia
  • Centre for Clinical Research, The University of Queensland, Royal Brisbane and Women’s Hospital Campus, Herston, Brisbane, QLD, Australia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Goce Dimeski
  • Chemical Pathology, Princess Alexandra Hospital, Woolloongabba, Brisbane, QLD, Australia
  • School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD, Australia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ John de Jersey
  • School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD, Australia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Lambro A. Johnson
  • Centre for Venomics Research, School of Medicine, The University of Queensland, Translational Research Institute, Woolloongabba, QLD, Australia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Michael Grant / Paul P. Masci
  • Centre for Venomics Research, School of Medicine, The University of Queensland, Translational Research Institute, Woolloongabba, QLD, Australia
  • Centre for Clinical Research, The University of Queensland, Royal Brisbane and Women’s Hospital Campus, Herston, Brisbane, QLD, Australia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Martin F. Lavin
  • Corresponding author
  • Centre for Clinical Research, The University of Queensland, Royal Brisbane and Women’s Hospital Campus, Herston, Brisbane, QLD 4029, Australia, Phone: +61 07 3346 6045, Fax: +61 07 3346 5509
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2018-09-29 | DOI: https://doi.org/10.1515/cclm-2018-0397

Abstract

Background

Incomplete blood clotting or latent clotting in serum is a common laboratory problem, especially for patients on anticoagulant therapy or when serum tubes are centrifuged before clotting is completed. We describe a novel approach to producing high-quality serum using snake venom prothrombin activator complex (OsPA) as an additive in blood collection tubes for non-anticoagulated (normal) individuals.

Methods

Plasma clotting assays were performed using a Hyland-Clotek instrument. Blood clotting was visually observed, and thromboelastography was also performed to determine the important parameters of coagulation. Thrombin generation was assayed using the chromogenic substrate S-2238, and biochemical analytes in the serum were determined on chemistry and immunoassay analysers. Fibrinogen was determined by either ELISA or Clauss fibrinogen assay.

Results

We initially showed that OsPA had strong coagulation activity in clotting not only recalcified citrated plasma and recalcified citrated whole blood, but also fresh whole blood in a clinical setting. The use of TEG clearly showed improved speed of clotting and generation of a firmer clot. We also showed that the use of OsPA to produce serum did not interfere with the determination of commonly measured biochemical analytes. The underlying clotting mechanism involves a burst of thrombin production at the initial stages of the clotting process upon contact with prothrombin in blood.

Conclusions

These results demonstrate rapid generation of high-quality serum, contributing to faster turnaround times with standardised quality samples, for accurate analyte determinations in normal individuals.

This article offers supplementary material which is provided at the end of the article.

Keywords: analyte determination; blood clotting; high-quality serum; prothrombin activators; snake venom proteins; thrombin generation

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About the article

Received: 2018-04-17

Accepted: 2018-08-31

Published Online: 2018-09-29

Published in Print: 2019-03-26


Author contributions: M.F.L, J.D.J., P.P.M., G.D., K.N.Z. and M.G. contributed to the conception of this project and designed the experiments. P.P.M., K.N.Z., L.A.J. and G.D. performed the experiments. K.N.Z. and G.D. organised and analysed data, and all authors reviewed and discussed. K.N.Z. and M.F.L wrote the paper with input from all authors on the drafting of the manuscript. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: MFL, PM, JdJ, MG and GD have Employee Share Options Scheme in Q-Sera. The funding organisation(s) played no role in the study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.


Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 57, Issue 4, Pages 483–497, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2018-0397.

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