Platelet Aggregation on CS-2500 - Home - English - … · 2016-09-26 · automatic formatting step ... (Gold Standard), anti-P2Y12 (Clopidogrel, Prasugrel…) • Heparin Induced

LD HH | F. Richir

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User Day Hemostasis 2016

Platelet Aggregation on CS-2500

With the collaboration

of Hyphen

François Richir September 2016

LD HH | F. Richir


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Hemostasis System Portfolio

Throughput

Sysmex® CA-660

64 TP/h

Sysmex® CS-2100i

180 TP/h

Sysmex® CS-5100

400 TP/h

Recent Instruments portfolio <4

years

INNOVANCE® PFA

BCS® XP

Sysmex® CS-2500

LD HH | F. Richir






The use of Platelet Aggregation?

Exploration of primary hemostasis: • Thrombopathies (Glanzmann Thrombastenia, Bernard Soulier…)

• Von Willebrand disease

• Antiplatelets drugs follow up: Aspirine (Gold Standard), anti-P2Y12 (Clopidogrel,

Prasugrel…)

• Heparin Induced Thrombocytopenia (HIT)

LD HH | F. Richir







University and central

hospital labs,

specialty labs, research labs

Antiplatelet

drug-therapy

management

Bleeding risk

management

Thrombophilia

and risk

factors

Standard

platelet

functionality

tests

Uncertain

Positive

Negative

Platelet

aggregation

testing

MULTIPLATE

CHRONOLOG HELENA

AGG RAM

VERIFYNOW

LD HH | F. Richir







• For one patient, we need 1 tube PPP & 1 tube PRP

• Platelet agonistes : (ADP, ristocétine…) at ≠ concentration

• Gradually increasing response helps for the interpretation

http://www.google.be/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjZ5ZfzuJ3PAhWLvBQKHTHTAdsQjRwIBw&url=http://www.practical-haemostasis.com/Platelets/platelet_function_testing_lta.html&bvm=bv.133178914,d.ZGg&psig=AFQjCNFLdOsA8qWngoHMKwoCghVUKFt84A&ust=1474443677083143

LD HH | F. Richir






No confusion with …

PFA • Closing time in seconds

• Replaces bleeding time

• Allows quick and easy screening

• 1st line test

Platelets Aggregation • Detailed platelet function

• Provides several advanced settings (max aggregation ,

AUC ... )

• Allows further detailed analysis

• 2nd line tests

LD HH | F. Richir






Decisional tree proposed

Syndrome hémorragique clinique

PFA (Cartouches ADP & EPI)

TCA NFS-Plaquettes

TO ADP N

TO EPI N

TO ADP N

TO EPI ↑↑

TO ADP ↑↑

TO EPI N ou ↑↑

TO ADP ↑↑

TO EPI ↑↑

Agrégation

Plaquettaire

Agrégation

Plaquettaire Dosages VWF

Agrégation

Plaquettaire Thrombopathie sécrétoire

Thrombopathie modérée

Aspirine et AINS Maladie de

Willebrand

Thrombopathie

Agrégation

Plaquettaire

Dosages VWF ↑

N

Pr Dine – CH Troyes – Siemens 2012

LD HH | F. Richir






Automatisation of platelet aggregation testing

Sysmex CS-2500 System

Man

ual

tim

e

Blood

sampling

Prepare (centrifuge

sample) Platelet-poor and platelet-rich plasma

Set stir-bar in sample cuvette

Au

tom

ated

tim

e Detection Results

Dispense PPP and PRP to sample cuvette

Add agonist to cuvette

Reduce steps, effort,

and complexity

*Sysmex CE-marked application.

Load the CB cuvettes

Automatic results produce clear aggregation reaction curves

LD HH | F. Richir






Automatisation of platelet aggregation testing

*Sysmex CE-marked application.



Normal

Glanzmann

Thrombasthenia

VWD

VWD Type 2B

LD HH | F. Richir






5 Agonists

ADP Epinephrin Collagen Arachidonic Acid Ristocetin

Exploration of Platelet secretion, P2Y12 Platelet adhesion

Platelet secretion and transformation,

aspirine

VWF and platelet aggregation

Kit content 0.625 mL x3 0.625 mL x3 0.625 mL x3 Dil:12 mL x3 0.625 mL x3 0.625 mL x3

Concentration 160 mM 0.8 mM 0.8 mg/mL 12 mM 12 mg/mL

Final Concentration 2 µmol/L 5 µmol/L 2 µgram/ml 1 mmol/L 1.2 mg/mL

Expiration date 12 m 12 m 12 m 18 m 30 m

Stability after

reconst.

2-8° 28 d 7 d 28 d 7 d 7 d

18-25° 24 h 24 h 24 h 24 h 8 h

-20° 2 m 2 m - 2 m 2 m

« Revohem » reagents From Hyphen / Distribution channel TBC

LD HH | F. Richir






Reagent management

40 reagents positions

LD HH | F. Richir






Cuvettes Management

24 (CS-2) to 40 (CS-5) cuvettes

Same cuvette than for

BC vW test (SB

cuvettes ref. 1041-9)

LD HH | F. Richir






Plasma management PPP & PRP (140 µL)

PRP

Patient 1

PPP

Patient 2

LD HH | F. Richir






Aggregation curve

Abs_PPP (mDO): PPP mDO

Abs_PRP (mDO): PRP mDO

Agg Max (%): Max Aggregation %

Fin (%): End point Aggregation %

Lag Phase Time (s):

Time from agoniste addition and aggregation start

AUC (%*S): Area under the aggregation curve

Vmax (%/s): Max velocity

VMax Time (S): Time for max velocity

Angle of Vmax: Vmax angle

LD HH | F. Richir






Curve superposition and smoothing

LD HH | F. Richir






Results exportation

Result exportation under .CSV format, impression, traceability

LD HH | F. Richir






First studies showing excellent results

Poster/Article

• Automation of Light Transmission Platelet Aggregation, University College London

• Precision and throughput of light transmission aggregometery on a routine coagulation analyser, University College London

• The Automation of Routine Light Transmission Platelet Aggregation on Sysmex CS-2000, ISTH 2015

LD HH | F. Richir






First studies showing excellent results

Lawrie & al. , The automation of routine light transmission platelet aggregation, International Journal of Laboratory

Hematology, October 2013

Patel & al. , Precision and throughput of light transmission aggregometery on a routine coagulation analyser,

September 2015

Need of 38% plasma less (140µL PRP vs 225µL)

Comparable curves profiles for 5 agonistes

Excellent CVs (1,6 < CV < 5,3%)

Time saving (28 min for 30 results on CS-5100)

Patel & al. , Precision and throughput of light transmission aggregometery on a routine coagulation analyser,

September 2015

LD HH | F. Richir






Thank you for your attention! Questions?

Documents

Platelet Aggregation on CS-2500 - Home - English - … · 2016-09-26 · automatic formatting step ... (Gold Standard), anti-P2Y12 (Clopidogrel, Prasugrel…) • Heparin Induced