D Dimer ve Preanalitik Hata Kaynakları
Synopsis
In this chapter titled "D-Dimer and Sources of Preanalytical Error" from the book "Current Biochemistry Studies II," the biochemical formation processes of the D-dimer biomarker within the framework of hemostasis and fibrinolysis mechanisms, its clinical application areas, current measurement methods, and preanalytical variables determining the accuracy of test results are thoroughly examined. D-dimer, generated through the conversion of fibrinogen into cross-linked fibrin polymers by thrombin and factor XIIIa, followed by degradation via plasmin, serves as a fundamental clinical parameter in the diagnosis and monitoring of conditions such as deep vein thrombosis, pulmonary thromboembolism, disseminated intravascular coagulation, and acute aortic aneurysm. The study presents a comparative overview of ELISA, ELFA, chemiluminescent (CLIA), latex-based immunoturbidimetric, and point-of-care (POC) testing methods in terms of sensitivity, specificity, turn-around times, device automation, and sample types. Focusing on the preanalytical phase responsible for approximately 60-70% of total laboratory errors, the chapter details phlebotomy needle gauges, sodium citrate anticoagulant fill ratios, butterfly set and tourniquet application durations, sample transport via pneumatic tube systems, centrifugation speeds, and storage stability conditions. Furthermore, the impacts and tolerance limits of major spectrophotometric and biological interference sources—such as in vitro hemolysis, lipemia, and hyperbilirubinemia—on D-dimer test results are explained in accordance with international guidelines.
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