What clinical use exactly? To diagnose platelet function disorders or test antiplatelet therapy?

Natalia raised a very important question.

Multiplate is a very good tool, PFA 100 as well, but only for a restricted number of clinical questions. ROTEM is not sensitive enough to answer most clinically relevant questions.

WE have experience with three systems. For the non-specialized lab setting I would suggest either of the two first solutions

Multiplate

- advantage: whole blood, easy to use (POCT)

- disadvantage: sensitive to hematocrit, platelet count and von Willebrand factor

- tests for aspirin (aspi test), clopidogrel (ADP), TRAP and others

- some data suggesting correlation with clinical outcome (Bonello et al.JACC 2010; 56:919-33)

PFA-200

- advantage: whole blood, only test assessing platelet function under actual flow conditions

- disadvantage: sensitive to hematocrit, platelet count and von Willebrand factor

- tests for aspirin (cololagen/epinephrin) and clopidogrel (P2Y12)

Born aggregometry

- advantage: considered gold standard by many, sensitive

- disadvantage: cumbersome, have to define own reference range, definitely not POCT

I've attached a poster presented at the 2013 National AACC conference. We looked at reliability and preicision of several plt fxn platforms using normal donors and donors taking aspirin and/or clopidogrel.

Take a look at www.plateletsolutions.co.uk for an approach that can be used in any healthcare setting.

Please take a look also at a new approach for high throughput platelet testing (antiplatelet therapy): Fruhwald, F; Macher, S; Haushofer, AC - Medizinische ...

https://forschung.medunigraz.at/.../suchen.publikationen_mug_autoren?..

Monitoring of dual platelet inhibition with a new standardized automated high-throughput ... Haushofer Alexander C. Macher Susanne · Prüller Florian · Raggam ...

I would recommend PAF-200 or else classic Born aggregometry or best Lumi aggregometry because it alows you to see not only aggregation but also secretion.

Lumi-Aggregometer works well for many platelet tests if used smartly with sm modifications. There is a new equipment called SONOCLOT which can detect clotting abnormalities and platelet function readily in whole blood widout need of any anticoagulant use.

I would agree with Marcus, FA 100 is a good enrty level machine for platelet function but need a little more clinical information regarding patients for testing.