Original Research

Impact of rapid centrifugation on routine coagulation assays in South Africa

Reola Haripersadh, Dashini Pillay, Nadine Rapiti
African Journal of Laboratory Medicine | Vol 11, No 1 | a1901 | DOI: https://doi.org/10.4102/ajlm.v11i1.1901 | © 2022 Reola Haripersadh, Dashini Pillay, Nadine Rapiti | This work is licensed under CC Attribution 4.0
Submitted: 24 March 2022 | Published: 28 November 2022

About the author(s)

Reola Haripersadh, Department of Haematology, National Health Laboratory Services, Inkosi Albert Luthuli Central Hospital, Durban, South Africa; and, Department of Haematology, School of Laboratory Medicine, University of KwaZulu-Natal, South Africa
Dashini Pillay, Department of Haematology, National Health Laboratory Services, Inkosi Albert Luthuli Central Hospital, Durban, South Africa; and, Department of Haematology, School of Laboratory Medicine, University of KwaZulu-Natal, South Africa
Nadine Rapiti, Department of Haematology, National Health Laboratory Services, Inkosi Albert Luthuli Central Hospital, Durban, South Africa; and, Department of Haematology, School of Laboratory Medicine, University of KwaZulu-Natal, South Africa


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Abstract

Background: The recommendation for coagulation blood samples is to centrifuge at 4000 revolutions per minute (rpm) for 15 min to produce platelet-poor plasma before analysis. Rapid centrifugation, defined as centrifuging samples at higher speeds for shorter durations, could potentially reduce turn-around times (TAT), provided sample integrity is maintained.

Objective: This study assessed the impact of rapid centrifugation on routine coagulation assay results.

Methods: Blood samples were collected from volunteers at Inkosi Albert Luthuli Central Hospital and King Edward VIII Hospital, Durban, KwaZulu-Natal, South Africa, from September to November 2021. Samples were centrifuged using Method A, the current standard (4000 rpm/15 min), Method B (4000 rpm/10 min), Method C (5000 rpm/10 min) and Method D (5000 rpm/5 min). Platelet count, prothrombin time, activated partial thromboplastin time, thrombin time (TT), fibrinogen and D-dimer levels were analysed and results from Methods B, C and D compared to reference Method A.

Results: Platelet-poor plasma was obtained from all samples (n = 60) using Methods A and B, and from 33/60 (55%) samples using Methods C and D. Differences between Method A and Methods C and D for normal prothrombin time, normal D-dimer and abnormal TT results were statistically significant. Prothrombin time results correlated strongly across all methods, while TT and D-dimer results correlated poorly. Activated partial thromboplastin time and fibrinogen results showed no significant differences across all methods.

Conclusion: Rapid centrifugation at 4000 rpm/10 min (Method B) showed results consistent with the reference method. This method could potentially reduce the overall TAT for routine coagulation assays.


Keywords

rapid centrifugation; coagulation assays; platelet-poor plasma; pre-analytic; Clinical and Laboratory Standards Institute guidelines; haemostasis

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