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J Thorac Cardiovasc Surg 2009;137:781-783
© 2009 The American Association for Thoracic Surgery

Brief Communication

The particle gel immunoassay as a rapid test to rule out heparin-induced thrombocytopenia?

^a University Clinic of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria
^b Department of Hematology and Stem Cell Transplantation, University Clinic of Internal Medicine, Medical University of Graz, Graz, Austria
^c Office for Biostatistics, Center for Medical Research, Medical University of Graz, Graz, Austria
^d Institute for Transfusion Medicine Dessau, Red Cross Blood Transfusion Service NSTOB, Dessau, Germany
^e Clinical Department of Blood Group Serology, Medical University of Vienna, Vienna, Austria

Received for publication November 27, 2007; accepted for publication March 18, 2008.

^_* Address for reprints: Simon Panzer, MD, Clinical Department of Blood Group Serology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria. (Email: simon.panzer@meduniwien.ac.at).

The first 20% of the full text of this article appears below.

Heparin-induced thrombocytopenia (HIT) is a prothrombotic condition characterized by a platelet decrease of 50% or thrombosis with a temporal relationship of 1 to 2 weeks after the initiation of heparin. These surrogate markers are useful for the clinical assessment¹ but are hardly applicable in multimorbid patients with clinical conditions that mimic HIT. Platelet activation assays (heparin-induced platelet activation [HIPA] and serotonin release assay) and platelet factor 4 (PF4)/polyanion enzyme-linked immunosorbent assay (ELISA) confirm HIT.² HIPA and serotonin release assay are highly specific, but they are laborious and require selected donor platelets and extended experience. High titer immunoglobulin (Ig)G antibodies correlate with clinical HIT,³ but ELISA is also time-consuming. The alternative heparin/PF4-antigen particle gel immunoassay (PaGIA) is easy, provides results within 1 hour, and detects mainly IgG but also IgA/M antibodies. We evaluated the specificity and sensitivity of PaGIA in relation to HIPA and ELISA in 285 patients with an undetermined likelihood for HIT with the intention to validate it as a rapid assay to exclude HIT.

Patients and Methods

Samples from 285 consecutive patients (median 71 years, range 1–97 . . . [Full Text of this Article]

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