title: Platelet function analyzer (PFA-100) offers higher sensitivity and specificity than thromboelastography (TEG) in detection of platelet dysfunction.
abstract: BACKGROUND
  The development of advanced surgical procedures requires novel and early diagnostic techniques. One of the prime difficulties that need to be overcome is an abnormality in the coagulation system. The blood clot formation and fibrinolysis processes are very complicated and important perioperatively. However, most of the major surgeries, such as liver transplantation, use thromboelastography (TEG) for detection of coagulation abnormalities, even though TEG is not actually an ideal option. Therefore, we compared the sensitivity and specificity of the platelet function analyzer (PFA-100) and thromboelastogram (TEG) in predicting platelet dysfunction and bleeding risk.
  
  
  METHODS
  Human blood samples were drawn from healthy volunteers for this study. Levobupivacaine and CGS21680 have antiplatelet effects which were used as the detection target. The platelet counts before comparison, platelet aggregation, the closure time of PFA-100, and the parameters of TEG were examined for data analysis.
  
  
  RESULTS
  Platelet aggregations were suppressed by all levobupivacaine doses (10 microg/mL, 50 micropg/mL, 200 microg/mL) and CGS21680 (100 nM, 500 nM, 1 microM) in a dose-dependent manner. Levobupivacaine and CGS21680 at maximal test doses produced no significant alteration in any parameter in the TEG assay. In the samples measured with PFA-100, both levobupivacaine and CGS21680 at maximal test doses significantly prolonged the closure time in the PFA-100 assay.
  
  
  CONCLUSIONS
  We conclude that PFA-100 offers a higher sensitivity and specificity than TEG in detection of platelet dysfunction.
authors.affiliation: Transgenic and Molecular Immunogenetics Laboratory, Chang Gung Memorial Hospital, Linkou, Taiwan, R.O.C.
authors.forename: Yao-Wen
authors.initials: YW
authors.lastname: Chang
authors.forename: Chang-Hui
authors.initials: CH
authors.lastname: Liao
authors.forename: Yuan-Ji
authors.initials: YJ
authors.lastname: Day
mesh_terms: D000241:Adenosine / Q000031:analogs & derivatives / Q000494:pharmacology; D002045:Bupivacaine / Q000031:analogs & derivatives / Q000494:pharmacology; D004305:Dose-Response Relationship, Drug; D006801:Humans; D000077554:Levobupivacaine; D010627:Phenethylamines / Q000494:pharmacology; D010974:Platelet Aggregation / Q000187:drug effects; D010979:Platelet Function Tests / Q000295:instrumentation*; D012680:Sensitivity and Specificity; D013916:Thrombelastography
chemical_list: D010627:Phenethylamines; C061282:2-(4-(2-carboxyethyl)phenethylamino)-5'-N-ethylcarboxamidoadenosine; D000077554:Levobupivacaine; D000241:Adenosine; D002045:Bupivacaine