Actually, nothing on this site is the last word, however I contacted Dennis J. Ernst, MT (ASCP), Center for Phlebotomy Education, about Donna Kaiser’s 4/5/13 acid-citrate-dextrose (ACD) tube question. Dennis’s response is: “Nice to hear from you. I haven’t heard anything about the use of ACD tubes in this context. I wonder if a tube manufacturer would shed light on it. It would be interesting to hear what the coag folks at BD would say.”
Following Dennis’s suggestion, I contacted Ana Stankovic, MD, Medical Director for BD Vacutainer. Dr. Stankovic was a pathology resident at the University of Alabama at Birmingham (UAB) a few years ago. She answered, “Hi George, unfortunately, we have no data to support this. When I was at Quest, I used citrate by itself in cases of platelet clumps. I do not know if that helps. All the best, Ana.”
So the answer is there is no answer, leaving Donna or others to set up a trial to learn if ACD tubes work as well as, or better than, citrate tubes, heparinized tubes, or EDTA. The results could be helpful for us who are often confronted with platelet satellitosis. Geo.
new approach (the addition of CaCl(2) + heparin mixture) was
new approach (the addition of CaCl(2) + heparin mixture) was recently published eqial to kanamycin supplemetation:
Novel method to dissociate platelet clumps in EDTA-dependent pseudothrombocytopenia based on the pathophysiological mechanism.
Chae H, Kim M, Lim J, Oh EJ, Kim Y, Han K.
Clin Chem Lab Med. 2012 Mar 3;50(8):1387-91
I have no experience with trying to get an accurate platelet
I have no experience with trying to get an accurate platelet count in patient with satellitism, but we have recently investigated the use of amikacin for EDTA-mediated clumping with good results. For me the most surprising outcome was that the platelet count declines when using citrate anticoagulant and I also found a publication backing up this observation. So beware, if using citrate to get an ‘accurate’ result, a relatively short time period for the platelet count to be performed on the citrate tube. Have others found the same?