Utility of the PFA-100 (R) for assessing bleeding disorders and monitoringtherapy: a review of analytical variables, benefits and limitations

The PFA-100(R) (platelet function analyser) is a relatively new tool for th e investigation of primary haemostasis. Recent studies have shown its utili ty in monitoring antiplatelet therapy (including aspirin) and as a screenin g tool for investigating possible von Willebrand disease (vWD) and various platelet disorders. More recently, the PFA-100(R) has been shown to be of v alue in monitoring DDAVP therapy in both vWD and platelet disorders. This p aper reviews current findings, details the utility of the PFA-100(R) for so me of these purposes, as well as reviewing analytical variables that may co mplicate the interpretation of results. The author highlights the benefits, as well as noting the limitations, of its use. Ultimately, the greatest st rengths of the PFA-100(R) are its simplicity in use and excellent sensitivi ty to particular haemostatic disturbances such as vWD, platelet disorders a nd platelet-affecting medication. However, because it is thus a 'global' te st system, this also creates a significant limitation, as the PFA-100(R) is not specific for, nor predictive of, any particular disorder. However, uti lized appropriately, the PFA-100(R) can be considered a worthwhile addition to any haemostasis laboratory involved in the diagnosis or therapeutic-mon itoring of bleeding disorders including vWD and platelet-dysfunctions. This review should be of value to both haemostasis scientists and clinical spec ialists.