Abstract
IntroductionFailure to obtain complete blood clotting in serum is a common laboratory problem. Our aim was to determine whether snake proth-rombin activators are effective in clotting blood and producing quality serum for analyte measurement in anticoagulated patients.Materials and methodsWhole blood clotting was studied in a total of 64 blood samples (41 controls, 20 Warfarin patients, 3 anticoagulated patients using snake venom prothrombin activator (OsPA)) with plain tubes. Coagulation was analysed using a visual assay, Hyland-Clotek and thromboelastography. Healthy control blood was spiked with a range of anticoagulants to determine the effectiveness of OsPa-induced clotting. A paired analysis of a Dabigatran patient and a control investigated the effectiveness of the OsPA clotting tubes. Biochemical analytes (N = 31) were determined for 7 samples on chemistry and immunoassay analysers and compared with commercial tubes.ResultsSnake venom prothrombin activators efficiently coagulated blood and plasma spiked with heparin and commonly used anticoagulants. Clotting was observed in the presence of anticoagulants whereas no clotting was observed in BDRST tubes containing 3 U/mL of heparin. Snake venom prothrombin activator enhanced heparinised blood clotting by shortening substantially the clotting time and improving significantly the strength of the clot. Comparison of 31 analytes from the blood of five healthy and two anticoagulated participants gave very good agreement between the analyte concentrations determined.ConclusionsOur results showed that the snake venom prothrombin activators OsPA and PtPA efficiently coagulated recalcified and fresh bloods with or without added anticoagulants. These procoagulants produced high quality serum for accurate analyte measurement.
Highlights
Failure to obtain complete blood clotting in serum is a common laboratory problem
Snake venom prothrombin activators efficiently coagulated blood and plasma spiked with heparin and commonly used anticoagulants
Clotting was observed in the presence of anticoagulants whereas no clotting was observed in BD Rapid Serum Tube (BDRST) tubes containing 3 U/mL of heparin
Summary
Our aim was to determine whether snake prothrombin activators are effective in clotting blood and producing quality serum for analyte measurement in anticoagulated patients. The presence of prothrombin activators (PA) in the venoms of snakes, including O. scutellatus (Australian coastal taipan, OsPA) and P. textilis (eastern brown snake, PtPA) causes rapid coagulation of blood [1,2]. These prothrombin activators do not require clotting co-factors such as calcium and phospholipids which are required by the mammalian prothrombinase complex [3,4].
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