Laboratory Diagnostics for Thrombosis and Hemostasis Testing-Part 2.

Welcome to a second themed issue of Seminars in Thrombosis and Hemostasis dedicated to laboratory diagnostics. In this issue, we will present several state-of-the art reviews highlighting hemostasis/thrombosis testing aspects relevant to a spectrum of bleeding and thrombotic disorders and treatments. The issue begins with a contribution by Adcock et al summarizing the performance of mixing studies to further evaluate the etiology of prolonged clotting times and differentiate factor deficiencies from factor inhibitors, inhibitor anticoagulants, and lupus anticoagulants.[1] Due to technical and interpretive non-standardization, combined with patient variables, there is no single approach to mixing studies that will correctly classify all cases as a deficiency or an inhibitor. Because mixing study results are often used as an early test to help determine what additional specialized testing is needed, it is vitally important to understand the pre-analytical, analytical, and post-analytical variables that affect the testing, including when the result patterns may be misleading. This review is an excellent summary of the variables that must be considered with each situation.