What are platelets and why are they important?
Platelets are small anucleate cells that circulate in the blood. They have a crucial role in haemostasis and thrombosis, and in preventing excessive bleeding after injury by forming a clot. This is done through closely linked interactions between blood vessel walls, circulating platelets and blood coagulation factors.
Unfortunately, some people experience platelet function disorders, which can be both acquired and congenital.
Light transmission aggregometry (LTA) is considered the gold standard technique for platelet function testing. But it is a technically challenging method affected by several factors in the pre-analytical (patient preparation, blood collection, specimen handling) and analytical (testing of specimen in lab) phases.
Despite being a widely used technique in specialised laboratories, LTA has not yet been fully standardised. So before providing this service, every laboratory must carry out several analysis and studies to assess the best criteria and conditions for patient preparation, blood collection, transport and testing conditions, and establish local laboratory specific normal reference ranges.
As part fulfilment of my MSc in biomedical science, I carried out a study to provide clarity on the best storage conditions for blood samples for platelet function testing. Three pre-analytical variables were investigated, namely: time of storage of sample, storage temperature of sample and separation method of sample.
The research, supervised by professor Alex Gatt, Kevin Vella and Mike Palmer, found the best conditions for sample storage and preparation for platelet function testing by LTA. Moreover, reference intervals for the Maltese population were established for all the agonists in this study.
Platelet function testing using LTA is a service that is going to be provided to the Maltese population. Currently, patients who require such testing need to make arrangements and go abroad, since there is no validated method for the storage of platelets which does not impact function. However, with the introduction of this aggregometer, cost and inconvenience would be minimised.
Its introduction at the Coagulation laboratory increases and improves available services by providing new platelet function tests and contributes towards promoting Malta’s bleeding clinic eligibility as a European Haemophilia Comprehensive Care Centre.
This study provided insight on the storage conditions required to provide adequate results with LTA, which helped towards starting this testing for the Maltese population.
Since only guidelines are provided for the LTA technique, it is critical that each practising laboratory establishes its own ideal storage conditions for reliable results, while consulting with the available literature.
The master’s degree was supported by the Tertiary Education Scholarship Scheme (TESS) managed by the Ministry of Education and Employment.