Rational, high quality laboratory monitoring before, during, and after infusion of prothrombin complex concentrates

Prothrombin complex concentrates (PCCs) have been used for over thirty year s to treat or prevent bleeding due to hemophilia B, vitamin K deficiency, w arfarin overdose, liver disease, or deficiency of one of the prothrombin co mplex factors. This article tries to answer the questions of which profile of laboratory assays is required for the establishment of the diagnosis; wh at are indications of replacement therapy with PCCs; how to monitor the the rapeutic effect; and how to monitor a possible prethrombotic state after PC C infusion. After proposing basic, standard, and optimal profiles of hemost aseological assays, the basic principal characteristics of a quality manage ment satisfying the requirements of good laboratory practice are discussed. (C) 1999 Elsevier Science Ltd. All rights reserved.