H e m a t o l o g y L a b o r a t o r y ( M T 1 1 8 ) Page 1

Activity 9: Clot Retraction off and it will remain intact. (Note: after pulling the
stick/rod and removing the clot, if the volume of
serum remaining is half the volume if the collected
DISCUSSION blood then, complete retraction has occurred)
• Testing the amount of time it takes for clotted 7. Record the results as to the degree of retraction
blood to contract measures the ability and and the quality of the clot (stable/unstable clot)
functionality of platelets. It is important to note that observed.
the test measures not only the quality of platelets
but also its level of activity. B. MAC FARLANE’S METHOD (SEMI-
• The test therefore is helpful not only in testing QUANTITATIVE)
thrombocytopenia but also functional properties 1. Collect 5mL of non-anticoagulated whole blood
(of platelets) as affected for instance by the intake and transfer it in a clean test tube.
of aspirins. 2. Placed a coiled wire/stick into the tube and cover
• Despite its high potential diagnostic importance, the test tube with a stopper/cork.
the test is affected by several interfering factor that 3. Place the tube at 37 degrees Celsius water bath
may not be controlled in the laboratory. until clot retraction is observed and a clot is
o May be due to the way it was performed or the formed. Clot formed after the first hour may be
process the student did removed by passing a wire/stick around the inside
• Other extraneous factors affecting the test include of the tube and allow the tube to be incubated
fibrinogen concentration and hematocrit. again for another hour.
• Within a few minutes after a clot is formed, it 4. After a firm clot is formed, the tube is allowed to
begins to contract and usually express most of the stand at room temperature until clot retraction is
fluid from the clot within 20-60 minutes. observes.
• Platelets are necessary to clot retraction. Failure 5. When retraction happens, carefully free the clot
of clot retraction is an indication that the number from the sides of the tube by removing the coiled
of platelets in the circulation is low. wire/stick with attached clot.
• As the clot retracts, the edges of the broken blood 6. Measure the volume of serum left remaining in the
vessel are pulled together thus contributing more tube
to the ultimate state of hemostasis. 7. Compute using this formula:
%Serum = (Volume of serum/ Volume of whole
MATERIALS blood) x 100
• Whole blood from venipuncture 8. Report the result in %. Evaluate the quality of the
• 13x100 mm test tube clot formed following the procedure in the Stefanini
• Blood collection set for venipuncture method.
PROCEDURE INTERPRETATION
A. STEFANINI METHOD • Partial retraction is observed within 30 minutes to
Commonly used method in clot retraction testing 2 hours.
1. Collect 5mL of non-anticoagulated whole blood • Clot retraction is nearly complete in 4 hours and
and transfer it in a clean test tube. definitely completed in 24 hours.
2. Place a stick/rod in the tube and cover it with a • Normal and complete retraction – approximately
stopper. Incubate the tube at 37 degrees Celsius. half the total volume is clot and the other half is
3. Take note of the clot retraction that takes place serum.
after 1,2,4 and 24 hours.
NORMAL VALUES FOR MAC FARLANE’S
4. Report the degree of clot retraction as:
METHOD:
A. Normal/ complete retractility
B. Partial retractility • CR% = 44-65%
C. Poor retractility
D. Very poor retractility Clot retraction is corrected by hematocrit in cases
5. In reporting the results, report the time and the of anemia, where the serum volume is increased
degree of retraction observed. and clot retraction is abnormally high.
6. To assess the firmness and quality of the formed • CORRECTED CR% = CR(%) X 100/100-Hct
clot, pull the stick/rod and place the clot across a
paper towel. A clot is stable if few cells will come