{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T16:15:47Z","timestamp":1777479347880,"version":"3.51.4"},"reference-count":15,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Appl Thromb Hemost"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:p>\n                    The activated partial thromboplastin time (APTT) assay is essential for evaluating coagulation. However, prolonged APTT may result from pathological conditions or contamination with unfractionated heparin (UFH), which can occur due to improper phlebotomy or use of heparinized lines\u2014even in patients not on UFH therapy. Distinguishing between true pathology and heparin contamination is critical for patient care and appropriate laboratory reporting. This study assessed the effectiveness of Antihepca HRRS (AHCa, a Heparin Resistant Recalcifying Solution (HRRS)), in neutralizing heparin interference in APTT testing. APTT results using AHCa HRRS and standard 0.025\u2005M CaCl\n                    <jats:sub>2<\/jats:sub>\n                    were compared in 33 heparinized and 41 non-heparinized patient samples on Sysmex CN-6000 and Stago Start Max analyzers. Additionally, 30 random plasma samples with prolonged APTT were tested, and heparin-spiked plasmas were used to determine AHCa HRRS's neutralization limit. AHCa HRRS fully corrected prolonged APTT in samples containing up to 0.6 IU\/mL UFH. In the 33 heparinized samples, AHCa HRRS reduced all APTT results to &lt;40\u2005s, eliminating the need for urgent reporting. Among the 30 prolonged APTT samples, 8 were corrected by AHCa HRRS (indicating heparin), 20 remained prolonged (suggesting other causes), and 1 was inconclusive. In non-heparinized samples, AHCa HRRS caused only minor APTT shortening (\u223c5%), confirming minimal impact on true results. Overall, AHCa HRRS effectively neutralizes UFH interference in APTT testing without compromising accuracy in non-heparinized samples. It offers a practical alternative to conventional calcium reagents and thrombin time for identifying heparin contamination in clinical laboratories.\n                  <\/jats:p>","DOI":"10.1177\/10760296251394365","type":"journal-article","created":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T16:26:42Z","timestamp":1764606402000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Detecting Heparin Contamination in Prolonged APTT with a Heparin-Resistant Solution"],"prefix":"10.1177","volume":"31","author":[{"given":"Elizabeth","family":"Crosby","sequence":"first","affiliation":[{"name":"Grange University Hospital, Cardiff Metropolitan University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Exner","sequence":"additional","affiliation":[{"name":"Haematex Research Pty Ltd, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1315-5760","authenticated-orcid":false,"given":"Manita","family":"Dangol","sequence":"additional","affiliation":[{"name":"Haematex Research Pty Ltd, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,12]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.164366"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1708032"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.18692"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-014-0613-x"},{"key":"e_1_3_3_6_2","unstructured":"Aarab R van Es J de Pont AC Vroom MB Middeldorp S. Monitoring of unfractionated heparin in critically ill patients. Neth J Med. 2013;71(9):466\u2013471."},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4939-7196-1_2"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.16757"},{"key":"e_1_3_3_9_2","unstructured":"Haematex Research. https:\/\/www.haematex.com\/haematex-products\/antihepca-hrrs. Accessed October 23 2024."},{"issue":"2","key":"e_1_3_3_10_2","first-page":"123","article-title":"Effect of haemolysis on coagulation tests: Prothrombin time and activated partial thromboplastin time","volume":"4","author":"Hernaningsih Y","year":"2017","unstructured":"Hernaningsih Y, Akualing JS. Effect of haemolysis on coagulation tests: Prothrombin time and activated partial thromboplastin time. J Med Lab Sci Technol. 2017;4(2):123\u2013127.","journal-title":"J Med Lab Sci Technol"},{"issue":"3","key":"e_1_3_3_11_2","first-page":"203","article-title":"Comparison of automated and semi-automated APTT assays in monitoring unfractionated heparin therapy","volume":"45","author":"Kim Y","year":"2022","unstructured":"Kim Y, Jo H, Kim S. Comparison of automated and semi-automated APTT assays in monitoring unfractionated heparin therapy. Clin Hematol. 2022;45(3):203\u2013210.","journal-title":"Clin Hematol"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1309\/LM749BQETKYPYPVM"},{"key":"e_1_3_3_13_2","volume-title":"Collection, Transport, and Processing of Blood Specimens for Testing Plasma-Based Coagulation Assays and Molecular Hemostasis Assays; Approved Guideline\u2014Sixth Edition","author":"Winkler Anne M.","year":"2017","unstructured":"Winkler Anne M., Worfolk Laura A., Castellone Donna, et. al.. Collection, Transport, and Processing of Blood Specimens for Testing Plasma-Based Coagulation Assays and Molecular Hemostasis Assays; Approved Guideline\u2014Sixth Edition. CLSI document H21-A6Clinical Laboratory Standards Institute (CLSI); 2017."},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/87.4.628"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/104.4.447"},{"issue":"2","key":"e_1_3_3_16_2","first-page":"731","article-title":"An update on laboratory detection and interpretation of antiphospholipid antibodies for diagnosis of antiphospholipid syndrome: Guidance from the ISTH-SSC subcommittee on lupus anticoagulant\/antiphospholipid antibodies","volume":"23","author":"Devreese KMJ","year":"2025","unstructured":"Devreese KMJ, Bertolaccini ML, Branch DW, et al. An update on laboratory detection and interpretation of antiphospholipid antibodies for diagnosis of antiphospholipid syndrome: Guidance from the ISTH-SSC subcommittee on lupus anticoagulant\/antiphospholipid antibodies. ISTH Guidance and Guidelines. 2025;23(2):731-744.","journal-title":"ISTH Guidance and Guidelines"}],"container-title":["Clinical and Applied Thrombosis\/Hemostasis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10760296251394365","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10760296251394365","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10760296251394365","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T14:05:27Z","timestamp":1777385127000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10760296251394365"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":15,"alternative-id":["10.1177\/10760296251394365"],"URL":"https:\/\/doi.org\/10.1177\/10760296251394365","relation":{},"ISSN":["1076-0296","1938-2723"],"issn-type":[{"value":"1076-0296","type":"print"},{"value":"1938-2723","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]},"article-number":"10760296251394365"}}