Optical clot detection systems have come a long way in recent years. The ACL TOP Family of analyzers use LED technology for our light source. These LED's read all of the clotting assays and some of the immunoturbidemeter assays (especially our D-Dimer HS)at a 671 nm wavelenght. At this higher wavelenght issues related to pre-analytical variables have been minimized because our systems read outside the range in which lipemia, bilirubin and hemoglobin influence measured absorbance. With testing like D-Dimer becoming more of a "routine" test, the ACL TOP systems are able to enjoy the advantage of the 671 wavelenght for our D-Dimer HS assay, the electro-mechanical clot detection systems are used only to measue clotting assays, and still rely on optical clot detection systems for immunoturbidemetric assasys such as D-Dimer, if these systems are using the older halogen lamp technology than they still could have the issues with pre-analytical variables like lipemia, bilirubin and hemoglobin.

We purchased 3 IL TOP analyzers and 9 Elites in March for Clarian Health. Since that time we have added an Elite at our Clarian Arnett site in Lafayette, IN. The analyzers are very fast, user friendly. The techs really like them compared to the slow MDA's that we came from. We are slowly adding tests to our special coag TOP and we are pleased with the IL special coag tests that we are using. We are still using some LIA Stago kits for ATIII Ag and it works well on the TOP. Over all, it has been a good fit and seamless conversion. One area that we struggled with was the new therapeutic range for UNFH. It was quite a bit different from the MDA range and clinician/pharmacy education was a must. Kim KInney

Our regional lab program purchased Sysmex coagulation analyzers from Dade-Behring 3 years ago, CA-1500 x 2 in the main lab and CA-560 x 5 in the rural labs. At our main lab we were replacing a MDA-180, originally from Organon-Teknika, then BioMerieux, now Trinity BioTech. We investigated Stago, Dade, BCI at that time also. All of the analyzers we looked at offered the testing platform that we were looking for. Each had some pros and cons, of course. My personal issue with the Sysmex analyzers is there lack of reagent management - although they are marketed with reagent management (there is a screen). The CA-1500 is unable to track the time-to-expiry from when the reagent is loaded and we have needed to invent a complicated "manual reagent log" to track the on-board expiry time. This function was easily performed by the MDA-180, so we were surprised by the lack of this function on the CA-1500. While the CA-1500 can perform factor assays, it can only do dilutions in groups of 3, so if we're doing 6 dilutions 1:5 to 1:160, we have to process the specimen twice. The factor assay graphs are difficult to interpret compared to what we were used to. Basically, we made our choice based on the bottom line, (underestimated, of course) and now we have a few regrets. We will not buy the Dade coagulation analyzers again.