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Platelet function testing

Paul Harrison, PhD
Section Editor
Lawrence LK Leung, MD
Deputy Editor
Jennifer S Tirnauer, MD


Platelets play a key role in both hemostasis and thrombosis. Accordingly, not only is accurate measurement of platelet function critical for identifying patients with platelet dysfunction or hyperfunction, but it also is becoming increasingly important for the monitoring of modern antiplatelet therapy.

The history of platelet function testing began over 100 years ago when platelets were first identified as distinct circulating cells, rather than fragments, and it was found that they were vital for both hemostasis and thrombosis [1]. Despite these early observations, for the majority of the 20th century the only means of assessing platelet function were a small number of fairly unreliable tests (eg, manual platelet count, inspection of the peripheral blood smear, bleeding time).

A major problem concerning the testing of platelet function is the difficulty in simulating hemostasis in vitro. In addition, platelets are sensitive to manipulation, and are prone to artifactual in vitro activation. Early attempts to simulate hemostasis in vitro included methods in which platelets were counted before and after exposure to foreign surfaces (eg, glass columns) or thrombus formation was monitored within closed plastic tube loops. Many of these early tests remained as research tools because of their technical difficulty, and were thus restricted to specialized centers.

The ability to test platelet function in the routine laboratory improved with the introduction of platelet aggregometry [2]. Remarkably, further advances in laboratory platelet analysis have lagged behind both the functional and molecular analysis of the coagulation/fibrinolytic system. The table (table 1) illustrates the small number of tests that were available up to the late 1980s. The availability of newer and more reliable platelet function analyzers, flow cytometry, and molecular biological techniques is changing our approach to platelet function analysis. Another table (table 2) lists a number of relatively new platelet function tests that are currently available.

This topic review will present a brief history of platelet function testing, and will review major advances in the analysis of platelet function.

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Literature review current through: Nov 2017. | This topic last updated: Aug 28, 2017.
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