May 2016

SYDNEY "CLOTTERS" MEETING

This group founded by Dr Jenny Curnow (Westmead Hospital) held an excellent meeting a few weeks ago in Sydney when Dr Claire McLintock (Auckland City Hospital) spoke about use of heparin in women with mechanical heart valves during pregnancy. This problem seems to be relatively unique to New Zealand where Islanders (Samoans mainly) tend to suffer the consequences of poorly-treated rubella. Vitamin K antagonists are contraindicated in early pregnancy and heparin is required at correct therapeutic levels. Timing of samples for anti FXa testing is important for achieving informative results, just as with NOAC testing.
"Breaking news!"; The ISTH recently announced that Dr McLintock would be the next chair of the ISTH, a very prestigious appointment. Congratulations Claire!
Dr David Rabbolini from the North Sydney Blood Centre presented new results of DNA analysis in several patients with newish inherited platelet defects. A number of interesting cases have been fully worked up with good information on genetic triggers for platelet abnormalities. Prof Chris Ward (RNSH) is co-ordinating an Australia-wide exercise and seeking more potential cases to investigate.

HEPARIN TESTING SOLUTIONS

Hyphen BioMed, France have an extensive range of kits for measuring heparins via anti FXa and anti-thrombin methods and these are being used by an increasing number of pharmaceutical companies and European hospitals. They can be used on almost any instrument platform and are very reliable. Calibrators and controls for many heparinoid agents including Orgaran, Arixtra, LMWH, UFH,(anti IIa for hirudins and argatroban) are also available as CE marked IVDs.

For example:
BIOPHEN kit #221011 - Liquid reagent, ready to use chromogenic assay for anti Xa activities (LMWH, UFH, Orgaran, Arixtra, also for Rivaroxaban and Apixaban) IVD approved, CE marked.
BIOPHEN #221025 - Chromogenic assay for measuring UF heparin with a 2 stage anti IIa method (2x100 tests). Follows Pharma and FDA recommendations.

Of course Hyphen BioMed also have a wide range of kits for NOACs and other quality products for coagulation testing and research. Factor deficient plasmas, APTT reagents, ELISAs for CBA, VWF, D-dimer, heparin antibodies, TPA and PAI-1 are available. Also enzymes such as thrombin, FXa and plasmin, chromogenic substrates, clotting factors and antibodies. Please look at the website, www.hyphen-biomed.com for more information and enquire to us for competitive pricing.
Haematex provides the unique product HRRS (heparin resistant recalcifying solution) for rapid identification by APTT correction of plasmas containing heparin. Now TGA approved and listed on the ARTG, #X9107-AE 12x5ml $120. See our handy flowchart (below) for "Dealing with Unexpected Heparin in APTT Test Plasmas".

LUPUS ANTICOAGULANTS

LA are "kind of" our speciality at Haematex and we are concerned about the high rate of false positive results obtained with currently-used dRVVT test reagents. These may lead to an incorrect diagnosis of APS in patients with an unprovoked thrombotic episode and perhaps more lengthy treatment with antithrombotic agents than necessary. Dr Tom Exner from Haematex will be doing a talk on this at the next ISTH LA subcommittee meeting in June.
Anyway, we have developed liquid-stable "ready for use" dRVT reagents which are equally (or more) sensitive to known LA as existing reagents but more specific for LA. The Screen/Confirm ratios are unaffected by VKA or NOACs which makes it possible to look for LA while patients are on antithrombotic therapies. Please try them out with a free sample (#X9701 6 x 8ml lupus sensitive and #X9702 6 x 8ml lupus resistant).

COLLAGEN

We have also recently developed a soluble and stable "ready for use" equine collagen (X#9310; 8ml vials 200ug/ml). Preliminary checks kindly carried out several expert labs have indicated that it may be just as good as the expensive imported collagens for aggregating platelets in both LTA and Multiplate applications. Please ask a free sample with your next order if you are interested in a lower cost option.