HAEMATOLOGY
Power in partnership: exploring novel light transmission aggregometry
The AUTOPLATE study group has used partnerships to offer improved evaluation of new light transmission aggregometry technology to diagnose platelet function disorders. George Tarpley explains how the group was established and looks at its progress so far.
Studies evaluating the performance of light transmission aggregometry (LTA) platforms typically suffer from smaller sample sizes and datasets when investigating platelet function disorders. This article will examine how the AUTOPLATE study group managed to overcome these challenges through multi- site collaboration and how this applies to other areas of research in rare diseases.
Light transmission aggregometry Light transmission aggregometry is considered the reference methodology for the investigation of suspected platelet function disorders. It is based on a spectrophotometric methodology first described by Born and O’Brien in the 1960s1,2
analysers were perceived as cumbersome, with the requirement of highly specialised scientists to manually add agonists to the reaction cuvette and be present in front of the analyser during the measurement period. Since the introduction of novel automated LTA analysers, this requirement is no longer, opening the door for less resource-burdened research. Systematic limitations aside, one of the most common challenges associated with research on platelet function disorders pertains to the availability of pathological specimens and sufficient PRP volume. A recent survey for inheritable platelet
disorders identified that only 0.3% of the general population were found to have genetic variants which were associated with a clinically meaningful loss of function in genes in inheritable platelet disorders,5
however, the United
Kingdom Haemophilia Centres Doctors organisation (UKHCDO) reported 1,354 patients with a heritable platelet disorder in the UK in 2023/24, demonstrating even lower registered prevalence of confirmed diagnoses in the UK population.6 In June 2021, the UK and Ireland saw the introduction of a new automated haemostasis analyser,
and has advanced very little since
its introduction to clinical practice at this time. LTA is based on the principle of light transmitting through a cuvette at 37°C containing platelet-rich plasma (PRP), and after the addition of an agonist, platelets aggregate in vitro, increasing light transmittance, which is then detected by a photodiode. The absence of aggregation to certain agonists, in combination with clinical criteria, is diagnostic for specific platelet function disorders. LTA is recommended under national and international guidelines as the screening method for the investigation of platelet function disorders and thus forms a key part of laboratory investigations in unexplained bleeding diatheses.3,4 Historically, large-scale performance evaluations of semi-automated LTA
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As platelet function disorders have a low prevalence, a common challenge when evaluating any new technology is the availability of both normal and pathological samples for evaluation.
JUNE 2025
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