Reappraisal of thromboplastin

Proficiency testing surveys in the state of New York indicate that despite increased sophistication in instrumentation, there has been no real improvement in interlaboratory reproducibility in prothrombin-time determinations over the last 10 years. This lack of improvement most pronounced in the therapeutic range of 20 to 30 sec. One reason may be that between types produced by the same manufacturer. While it has been possible in several laboratories to synthesize experimentally a thromboplastin with known content of lipid and active protein, no efforts have been made to make such a product by the same manufactures. While it has been made to make such a product commercially available. Blood levels of of warfarin were measured but cannot be reliably used to monitor anticoagulation. In a preliminary study, factor Xa activity was measured using chromogenic substrate S2222. Factor Xa activity gave a positive correlation with prothrombin times of patients receiving warfarin therapy. Chromogenic substrate factor assays may represent a future method of choice for controlling anticoagulant therapy.