MAY 20, 2013 8:00 AM PDT

Monitoring Heparin in the Clinical Laboratory

Sponsored by: Diagnostica Stago, Inc.
  • Associate Professor, College of Medicine Department of Pathology, Immunology and Laboratory Medicine, University of Florida
      Dr. Neil S. Harris is board-certified in anatomic and clinical pathology, as well as clinical chemistry through the American Board of Clinical Chemistry. He is currently the director of the core (chemistry/hematology) laboratory, in addition to being a clinical associate professor at the Department of Pathology, Immunology and Laboratory Medicine within the University of Florida's College of Medicine. Dr. Harris received his undergraduate and medical education at the University of Cape Town in South Africa. In the 1980s, his postgraduate training included a residency in clinical pathology (chemical pathology & immunology) in the Division of Pathology at the University of Cape Town. This was followed by a research fellowship in the Division of Hematology/Oncology and a fellowship in clinical chemistry at the Department of Laboratory Medicine at the Children's Hospital in Boston, Massachusetts. He obtained his USA credentials in pathology by completing his residency at Fletcher Allen Health Care in at the University of Vermont in Burlington.


    Unfractionated heparin (UFH, commonly called heparin) is an indirect anticoagulant commonly administered prophylactically to inpatients at risk of thrombosis.  Anticoagulants, including UFH, are considered high alert medications when used for treatment. As such, assays monitoring levels of UFH are extremely important to avoid adverse effects for patients. This activity will provide improved understanding for clinicians and laboratorians related to the monitoring of UFH and related forms of heparin.  Emphasis will be placed on the role of the chromogenic anti-Xa assay as a measure of heparin activity along with clinical scenarios and outcomes studies.

    • Describe the biochemical nature of heparin including low molecular weight heparin (LMWH) and ultra-low molecular weight synthetic forms such as fondaparinux.
    • Review the anticoagulant mechanism of action of these various forms of heparin.
    • Compare the activated PTT and the anti-Xa assay as a means of monitoring heparin.
    • Explain the role of ATIII supplementation in the anti-Xa assay and its consequences.
    • Discuss the clinical consequences of anti-Xa monitoring in the context of clinical scenarios.

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