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There are three types of laboratory assays available:
The functional assay (SRA) is performed by measuring radioactive serotonin release from washed platelets in the presence of the patient’s serum and an appropriate concentration of heparin. The HIPA measures the activity of the antibody/PF4/heparin complex.[38] Immunoassays detect the presence of HIT antibodies. [38] Studies performed in the 1980s demonstrated that platelet aggregation assays are much less sensitive than the SRA. [38] How do SRA, HIPA and immunoassays compare?The immunoassays are more likely to detect clinically insignificant HIT antibodies, compared with the more sensitive washed platelet aggregation assays. Therefore, these assays are more likely to be falsely positive than the SRA. On the other hand, a negative antigen assay is better at ruling out the presence of antibodies.[38]How is the more recent PIFA® method different from other testing methods?Most testing methods take hours to perform. Because of the turnaround time and the special instrumentation needed, most tests are not conducive to cost-effectively or efficiently processing single patient samples. PIFA® is a single-use, single patient test that can determine a patient’s HIT antibody status in approximately 10 minutes. [41, 42]Comparative chart of laboratory testing for HIT[38-42]
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