A Digital Microfluidic Approach to Accurate Heparin Monitoring in DOAC-Treated Patients

Patients on direct oral anticoagulants (DOACs) may need to transition to heparin during surgery or when rapid reversal of anticoagulation is necessary. The presence of residual DOACs is known to interfere with anti-Factor Xa (aFXa) tests, which can delay treatment decisions.

At the 2025 Annual Meeting of the Association for Diagnostic Laboratory Medicine (ADLM) in Chicago, a rapid (<15 minute) anti-Factor Xa test developed on a point-of-care digital microfluidic (DMF) platform was presented in collaboration with Cleveland Clinic (Cleveland, OH, USA). In this study, we examined interference or lack thereof with apixaban and rivaroxaban. The digital microfluidic aFXa test remained remarkably tolerant to the presence of these DOACs.

This novel approach could enhance anticoagulation management in patients transitioning from DOACs to unfractionated heparin. Further clinical studies are underway to establish clinical performance.

Click here to view the poster.

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   5. Novel Fluorometric Assay for Pediatric Anti-Factor Xa Testing: Minimizing Bilirubin and Hemolysis Interference in Whole Blood