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Discard tubes are not necessary when drawing samples for specialized coagulation testing

Smock, Kristi Ja,b; Crist, Ronda Ab; Hansen, Sarah Jb; Rodgers, George Ma,b,c; Lehman, Christopher Ma,b

Blood Coagulation & Fibrinolysis: April 2010 - Volume 21 - Issue 3 - p 279–282
doi: 10.1097/MBC.0b013e3283380d12
Original Articles

Discard tubes have traditionally been obtained when drawing samples for coagulation testing to avoid potential tissue factor activation of coagulation in the first tube that may lead to inaccurate results. Although discard tubes are no longer required for prothrombin time and partial thromboplastin time, the practice is still recommended for other coagulation studies due to lack of sufficient evidence that discard tubes are not needed. The objective of the present study was to determine whether the first citrate tube drawn can be used for special coagulation testing. We performed testing for fibrinogen, D-dimer, factors VIII, IX, XI, proteins C and S, and antithrombin on 30 healthy individuals and factors II, VII, IX, X, and proteins C and S on a second group of 30 healthy individuals and 30 individuals receiving warfarin. Testing was performed on two consecutive samples to evaluate the level of agreement between the two tubes. Paired t-testing showed no statistically significant differences between tube 1 and tube 2 for any of the tests performed. Most data pairs (tube 1, tube 2) agreed within 10% difference or less, and no positive or negative biases were observed. To our knowledge, this study is the first to evaluate the need for discard tubes in a variety of coagulation tests using both normal and abnormal samples. Our data suggest that discard tubes are not necessary when drawing samples for specialized coagulation testing.

aDepartment of Pathology, USA

bARUP Institute for Clinical and Experimental Pathology, USA

cDepartment of Medicine, University of Utah Health Sciences Center, Salt Lake City, Utah, USA

Received 5 November, 2009

Accepted 27 January, 2010

Correspondence to Kristi J. Smock, ARUP Laboratories, 500 Chipeta Way, Salt Lake City, UT 84108, USA Tel: +1 801 583 2787x2154; fax: +1 801 584 5207; e-mail:

© 2010 Lippincott Williams & Wilkins, Inc.