Fibrinolysis during liver transplantation: analysis by the Thrombodynamics method

2019 ◽  
Vol 72 (9) ◽  
pp. 636-638
Author(s):  
Stéphanie Roullet ◽  
Sylvie Labrouche ◽  
Geneviève Freyburger
Keyword(s):  
Liver Transplantation ◽  
Observational Study ◽  
Dynamic Analysis ◽  
Fibrin Clot ◽  
Clot Lysis ◽  
Lysis Time ◽  
Three Samples ◽  
Euglobulin Clot Lysis Time ◽  
Fibrinolytic Capacity ◽  
Clot Lysis Time

An issue in orthotopic liver transplantation (OLT) is the diagnosis of hyperfibrinolysis. The Thrombodynamics-4D assay (TD4D) is a videomicroscopy system allowing the dynamic analysis of fibrin clot. Fibrinolysis is highlighted by a change in clot intensity. The aim of this observational study was to evaluate the TD4D as a tool to diagnose fibrinolysis during OLT. Thirty consecutive patients were included. We studied a subset of 41 samples from 13 patients who demonstrated hyperfibrinolysis during OLT by global fibrinolytic capacity studied by the Lysis Timer (GFC/LT) and/or euglobulin clot lysis time (ECLT) and/or EXTEM maximum lysis (EXTEM ML) on ROTEM. Three samples exhibited fibrinolysis. They exhibited significantly shorter ECLT, higher lysis on EXTEM graphs, shorter GFC/LT clot lysis time and higher t-PA activity values. After adding urokinase, 13 samples exhibited fibrinolysis. In conclusion, TD4D allows the dynamic analysis of fibrin clot formation and lysis. It only recognises the most severe forms of hyperfibrinolysis during OLT.

Altered fibrin clot structure/function in patients with antiphospholipid syndrome: association with thrombotic manifestation

2014 ◽  
Vol 112 (08) ◽  
pp. 287-296 ◽  
Author(s):  
Magdalena Celińska-Löwenhoff ◽  
Teresa Iwaniec ◽  
Agnieszka Padjas ◽  
Jacek Musiał ◽  
Anetta Undas
Keyword(s):  
Structure Function ◽  
Antiphospholipid Syndrome ◽  
Thrombotic Event ◽  
Fibrin Clot ◽  
Clot Lysis ◽  
Lag Phase ◽  
Lysis Time ◽  
Clot Structure ◽  
Clot Lysis Time ◽  
D Dimer

SummaryWe tested the hypothesis that plasma fibrin clot structure/function is unfavourably altered in patients with antiphospholipid syndrome (APS). Ex vivo plasma clot permeability, turbidity and susceptibility to lysis were determined in 126 consecutive patients with APS enrolled five months or more since thrombotic event vs 105 controls. Patients with both primary and secondary APS were characterised by 11% lower clot permeability (p<0.001), 4.8% shorter lag phase (p<0.001), 10% longer clot lysis time (p<0.001), and 4.7% higher maximum level of D-dimer released from clots (p=0.02) as compared to the controls. Scanning electron microscopy images confirmed denser fibrin networks composed of thinner fibres in APS. Clots from patients with “triple-antibody positivity” were formed after shorter lag phase (p=0.019) and were lysed at a slower rate (p=0.004) than in the remainder. Clots from APS patients who experienced stroke and/or myocardial infarction were 8% less permeable (p=0.01) and susceptible to lysis (10.4% longer clot lysis time [p=0.006] and 4.5% slower release of D-dimer from clots [p=0.01]) compared with those following venous thromboembolism alone. Multivariate analysis adjusted for potential confounders showed that in APS patients, lupus anticoagulant and “triple-positivity” were the independent predictors of clot permeability, while “triple-positivity” predicted lysis time. We conclude that APS is associated with prothrombotic plasma fibrin clot phenotype, with more pronounced abnormalities in arterial thrombosis. Molecular background for this novel prothrombotic mechanism in APS remains to be established.

scholarly journals BβArg448Lys polymorphism is associated with altered fibrin clot structure and fibrinolysis in type 2 diabetes

2017 ◽  
Vol 117 (02) ◽  
pp. 295-302 ◽  
Author(s):  
Katie A. Greenhalgh ◽  
Mark W. Strachan ◽  
Saad Alzahrani ◽  
Paul D. Baxter ◽  
Kristina F. Standeven ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Fibrin Clot ◽  
Clot Lysis ◽  
Plasma Clot ◽  
Lysis Time ◽  
Increased Risk ◽  
Fibrin Network ◽  
Clot Lysis Time ◽  
Fibrin Clots

SummaryBoth type 2 diabetes (T2DM) and Bß448Lys variant of fibrinogen are associated with dense fibrin clots, impaired fibrinolysis and increased cardiovascular risk. It was our objective to investigate whether BßArg448Lys adds to vascular risk by modulating fibrin network structure and/or fibrinolysis in diabetes. The primary aim was to study effects of BßArg448Lys on fibrin network characteristics in T2DM. Secondary aims investigated interactions between gender and BßArg448Lys substitution in relation to fibrin clot properties and vascular disease. Genotyping for BßArg448Lys and dynamic clot studies were carried out on 822 T2DM patients enrolled in the Edinburgh Type 2 Diabetes Study. Turbidimetric assays of individual plasma samples analysed fibrin clot characteristics with additional experiments conducted on clots made from purified fibrinogen, further examined by confocal and electron microscopy. Plasma clot lysis time in Bß448Lys was longer than Bß448Arg variant (mean ± SD; 763 ± 322 and 719 ± 351 seconds [s], respectively; p<0.05). Clots made from plasma-purified fibrinogen of individuals with Arg/Arg, Arg/Lys and Lys/Lys genotypes showed differences in fibre thickness (46.75 ± 8.07, 38.40 ± 6.04 and 25 ± 4.99 nm, respectively; p<0.001) and clot lysis time (419 ± 64, 442 ± 87 and 517 ± 65 s, respectively; p=0.02), directly implicating the polymorphism in the observed changes. Women with Bß448Lys genotype had increased risk of cerebrovascular events and were younger compared with Bß448Arg variant (67.2 ± 4.0 and 68.2 ± 4.4 years, respectively; p=0.035). In conclusion, fibrinogen Bβ448Lys variant is associated with thrombotic fibrin clots in diabetes independently of traditional risk factors. Prospective studies are warranted to fully understand the role of BβArg448Lys in predisposition to vascular ischaemia in T2DM with the potential to develop individualised antithrombotic management strategies.

Relationships between Euglobulin Clot Lysis Time and the Plasma Levels of Tissue Plasminogen Activator and Plasminogen Activator Inhibitor 1

1990 ◽  
Vol 63 (01) ◽  
pp. 082-086 ◽  
Author(s):  
Tetsumei Urano ◽  
Kenji Sakakibara ◽  
Andrzej Rydzewski ◽  
Shoko Urano ◽  
Yumiko Takada ◽  
...  
Keyword(s):  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Slight Modification ◽  
Clot Lysis ◽  
Plasminogen Activator Inhibitor 1 ◽  
Lysis Time ◽  
Tissue Plasminogen ◽  
Euglobulin Clot Lysis Time ◽  
Pai 1 ◽  
Clot Lysis Time

SummaryThe relationships between tissue plasminogen activator (tPA), its fast acting inhibitor (PAI-1) and euglobulin clot lysis time (ELT) were investigated with healthy volunteers’ plasma. Turbidimetric clot lysis assay by the microtiter plate reader was utilized for ELT with a slight modification. Both tPA and PAI-1 showed the significant correlation with ELT. tPA had a significantly positive, not negative, correlation with ELT (R = 0.387, p <0.001). Higher correlation coefficients (R = 0.580, p <0.001 and R = 0.599, p <0.001) were obtained between ELT and total PAI-1 or free PAI-1 than tPA or tPA-PAI-1 complex (R = 0.427, p <0.001). The positive correlation was also obtained between tPA and PAI-1. These data suggest that PAI-1 is a highly important factor for ELT, especially, the amounts of free PAI-1 being the key factor to determine the ELT, which can represent the potential activity of the fibrinolytic system.

Relationship between Plasma Fibrinolytic Activity and Serum Fibrinogen Degradation Products (FDP) Tested by Various Methods

1971 ◽  
Vol 26 (01) ◽  
pp. 083-087 ◽  
Author(s):  
B Lipiński ◽  
A Nowak ◽  
A Odrzywolska ◽  
J Dosiak
Keyword(s):  
Healthy Subjects ◽  
Fibrinolytic Activity ◽  
Degradation Products ◽  
Clot Lysis ◽  
Proteolytic Degradation ◽  
Fibrinogen Degradation Products ◽  
Lysis Time ◽  
Euglobulin Clot Lysis Time ◽  
Fibrinogen Content ◽  
Clot Lysis Time

SummaryIt was found in the present work that the level of serum fibrinogen degradation products (FDP) determined by the immunoassay method correlated well with the staphylococcal clumping titer in serum (correlation coefficient r = 0.68). The content of FDP in serum of 30 healthy subjects and patients with various diseases did not correlate, however, neither with blood fibrinolytic activity estimated by the euglobulin clot lysis time, nor with fibrinogen content and plasma anticlotting activity. It is concluded, that FDP appear in circulation as a result of local proteolytic degradation of intravascularly deposited fibrin without generalized activation of fibrinolysis.

Changes in Platelet Function, Blood Coagulation and Fibrinolysis During Insulin-Induced Hypoglycaemia in Juvenile Diabetics and Normal Subjects

1982 ◽  
Vol 47 (03) ◽  
pp. 254-258 ◽  
Author(s):  
J Dalsgaard-Nielsen ◽  
S Madsbad ◽  
J Hilsted
Keyword(s):  
Insulin Infusion ◽  
Adenosine Diphosphate ◽  
Normal Subjects ◽  
Clot Lysis ◽  
Control Group ◽  
Lysis Time ◽  
Euglobulin Clot Lysis Time ◽  
Juvenile Diabetics ◽  
Clot Lysis Time

SummaryHaemostatic parameters were assessed before insulin induced hypoglycaemia and 0, 1 and 2 fu after discontinuation of insulin infusion in 7 non-diabetics, aged 28 (22-31) years (mean and range), and 8 juvenile diabetics, aged 3L (27-35) years, with a mean duration of diabetes of 4 years. The patients were normoglycaemic for at least L0 hr before the study.Platelet aggregation in vitro was induced by lower adenosine diphosphate (ADP) concentrations in the diabetics than in the controls before hypoglycaemia and 0 and 60 min after insulin infusion. Platelet counts decreased significantly in the diabetics after hypoglycaemia, whereas no changes were seen in the control group. The activated partial thromboplastin time (APTT) was reduced in both groups and significantly lower in the diabetics than in the controls 120 min after insulin infusion.Fibrinogen and factor VIII R: Ag increased after insulin infusion; highest values were seen in the diabetics. The euglobulin clot lysis time (ELT) was reduced in both groups during insulin infusion; L20 min after end of insulin infusion ELT was significantly longer in the diabetics than in the control group.

scholarly journals Accelerated Hemostasis in Coronary Artery Disease

1977 ◽  
Author(s):  
T. Wajima ◽  
L. L. Burkett
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Antithrombin Iii ◽  
Artery Bypass ◽  
Laboratory Data ◽  
Clot Lysis ◽  
Lysis Time ◽  
Euglobulin Clot Lysis Time ◽  
Artery Disease ◽  
Clot Lysis Time

Reduced antithrombin III levels and positive paracoagulation tests occur in some cases of coronary artery disease. This could be related to the cause of atherosclerosis or it could be the result of the disease itself. Thirty-one patients who had arteriosclerotic heart disease, well documented coronary artery occulusions (1-2 vessels), and were subjected to coronary artery bypass surgery were studied for active hemostatic mechanisms of coagulation. Plasma fibrino-peptide A (FPA) levels, fibrinogen, paracoagulation tests, and antithrombin III assays were performed. In addition, PT, PTT, TT, ECLT, and EDP were examined. The blood samples were taken 2-3 days before surgery. Ten of 31 had elevated levels of FPA, and 21 had normal FPA. Eleven patients had positive paracoagulation tests. Six of 31 showed decreased antithrombin III. Seven had an increased fibrinogen level (over 500 mg%). Four of ten patients with elevated FPA had positive tests for paracoagulation, decreased antithrombin III and increased fibrinogen. PT, PTT, TT, Platelet counts, FDP, and ECLT were normal in all patients, except three who had shortened euglobulin clot lysis time. Evidence for activated fibrinolysis was not observed except in 3 cases with shortened englobulin clot lysis time. There was no difference between elevated FPA groups and normal groups in the postoperative period. The degree or extent of coronary artery occulsion was not correlated with the level of FPA or positive paracoagulation tests. Since there were no clinical and laboratory data suggesting disseminated intravascular coagulation, the increased FPA, positive paracoagulation and the reduced level of antithrombin III strongly favor an accelerated hemostatis, probably of localized nature.

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