The APTT mixing study is done to determine if a prolonged APTT is due to coagulation factor deficiency or the presence of an inhibitor.

Control (normal) plasma contains a normal amount of coagulation factors, so mixing patient plasma with the control plasma should correct the APTT to the normal range (most APTTs do not prolong unless factor levels are < 50%).

• The APTT is performed on the patient’s plasma, the normal control plasma and a 50:50 mix. If the APTT fully corrects to the normal range, then the prolongation of the APTT is due to a coagulation factor deficiency.
• If it does not correct to the normal range, then it is most likely due to the presence of an inhibitor.

When the APTT is only mildly prolonged, it can be difficult to tell the difference between correction and non-correction on the APTT mix. Inhibitor screens or factor levels should be performed for such patients to distinguish between coagulation factor deficiency and the presence of an inhibitor.

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