MEDTECH LEC
HEMATOLOGY II
TERM 02
FIBRINOLYSIS
LABORATORY
FIBRINOLYSIS
Primary purpose is to digest fibrin clots
as they are formed in order to keep
vascular system free of deposited fibrin
and fibrin clots
Occurs when plasminogen is converted
to plasmin, which dissolves the fibrin or
fibrinogen into smaller fragments
termed FDP (fibrin degradation
product) or FSP (fibrin split product)
Plasminogen – a single chain
glycoprotein found in the plasma in
concentration of 20 to 40 mg/dl and in
all other fluids in a lesser amount.
Plasmin – a serine protease that
systematically digest fibrin polymer by
the hydrolysis of arginine-related and
lysine related peptide bonds PLASMINOGEN ACTIVATORS
Free plasmin- capable of digesting 1. Intrinsic factors= factor XIIa,
plasma Fibrinogen, Factor V, factor VIII, Kallikrein, and HMWK
and Fibronectin.
2. Tissue type urokinase- secreted by the
kidney, activates plasminogen
3. Therapeutic activators such as
treatment for thromboemboli
4. Streptokinase, urokinase, tissue like
PA
5. Tissue plasminogen activator
INHIBITORS OF FIBRINOLYSIS
1. Alpha 2 antiplasmin – primary
inhibitor of plasmin
2. Alpha 2 macroglobulin
3. Thrombospondin – released by the
platelets, inhibits activation of fibrin-
bound plasminogen
LEC HEMATOLOGY II 1
MEDTECH LEC
HEMATOLOGY II
TERM 02
4. Plasminogen activator inhibitor 1 • These two methods are preferred
(PAI-1) and plasminogen activator because it requires that a few volume of
inhibitor 2 (PAI-2) blood should be discarded first then the
next volume of blood is collected, this is
5. Alpha 1 antitrypsin
done to prevent possible contamination
of tissue fluid that contains
thromboplastin which somehow alters
results obtain from clotting test
SPECIAL CONSIDERATIONS AND INFORMATION
Anticoagulant- 0.105 to 0.109m (3.2%)
buffered sodium citrate
Ratio of blood to anticoagulant – (9:1)
Citrate is the anticoagulant of choice for
platelet function testing except for the
glass bead retention test, which require
heparin.
Specimen processing for hemostasis
testing should be done at 37 ‘c
Labile factors (V and VIII) deteriorate at
RT and increased pH
Factors VII and XI prematurely activates
when place at a cold temperature (4’c)
Aspirin and other NSAID’s inhibit
cyclooxygenase pathway
• Platelet function test: 1 week
abstinence from the following
drugs
• Bleeding time test: 24 hours
aspirin intake is prohibited
Platelet poor plasma (PPP)
• Centrifuged at 2000 x g for 10
minutes (steinenger)
• Centrifuged at 1500 x g for 15
SPECIMEN COLLECTION AND PROCESSING FOR minutes (rodak’s)
HEMOSTASIS TESTING
• Centrifuged at 2500 x g for 20
METHOD OF COLLECTION minutes (turgeon)
• Two syringe method
• Evacuated tube technique
LEC HEMATOLOGY II 2
MEDTECH LEC
HEMATOLOGY II
TERM 02
Platelet rich plasma (PRP)
• Centrifuged at 60-100 x g for 10
minutes (steinenger)
• Centrifuged by 50 x g for
30minutes (rodak’s)
Coagulation specimen should be
centrifuged within 1 hour of obtaining
the sample
FACTORS THAT INTERFERE WITH THE VALIDITY OF CLOT
Specimen processing for PT is valid BASED TEST RESULTS
within 24 hours
Specimen processing for APTT is valid
for 4 hours
The PT and APTT, TCT are prolonged
when fibrinogen level is ≤100mg/dL
(rodak)
The size of glass test tube used for PT
and APTT is 12 x75mm (steinenger),
or 13x 100mm (brown)
PRP (platelet rich plasma)
• Can be obtained by centrifuging WB
collected from 3.2% sodium citrate
at 50g x for 30 minutes
• It contains 200,000 to 300,000 /uL
platelets (200 to 300 x109/L
platelets)
• It is used for platelet aggregometry
or platelet function test
PPP (platelet poor plasma)
• Can be obtained by centrifuging WB
collected from 3.2% sodium citrate
at 1500g x for 15 minutes
• It contains less than 10,000/uL
platelets
• It is used for clot-based coagulation
test (E.G PT and APTT)
LEC HEMATOLOGY II 3
