Personalized approach to procurement of hemocomponents taking into account hemostasis characteristics of donors

2018 ◽  
Author(s):  
А.Ф. Кубиддинов ◽  
Д.С. Саидов ◽  
М.З. Тагожонов ◽  
А.А. Одинаев ◽  
З.Ф. Тагожонов ◽  
...  
Keyword(s):  
Platelet Aggregation ◽  
Factor Viii ◽  
Blood Clotting ◽  
International Normalized Ratio ◽  
Blood Components ◽  
Transfusion Therapy ◽  
At Iii ◽  
Personalized Approach ◽  
Von Willebrand ◽  
Fibrinogen Content

Цель исследования: изучение параметров гемостаза у доноров для оптимизации использования компонентов крови у пациентов с нарушениями свертывания крови. Материалы и методы. Проанализированы результаты коагулологического исследования крови у 200 доноров. Контрольную группу составили 50 человек — здоровые люди (добровольцы), не доноры в возрасте от 20 до 60 лет. Измеряли: время свертывание крови по Ли-Уайту, активированное частичное тромбопластиновое время, международное нормализованное отношение, агрегацию тромбоцитов, антитромбин III (АТ-III), содержание фибриногена по Клаусу, фактор фон Виллебранда (ФВ), активность фактора VIII. Рассчитывали среднюю арифметическую и среднюю ошибку средней арифметической (М ± m), для оценки значимости различий средних величин использовали t-критерий Стьюдента, различия считали статистически значимыми при р < 0,05. Результаты. Оценка показателей гемостаза показала как развитие у доноров склонности к гиперкоагуляции, так и компенсаторную активацию антикоагулянтной системы. В зависимости от возраста и количества кровосдач агрегация тромбоцитов, АТ-III, содержание фибриногена, активность ФВ и фактора VIII в заготовленных компонентах крови получаются различными. Заключение. Трансфузионная терапия коагулопатий может быть оптимизирована за счет применения компонентов крови, целенаправленно заготовленных с учетом характера нарушений свертывания крови у реципиента. Aim: to optimize the usage of blood components in patients with coagulopathy we analyze some hemostasis parameters in donors. Materials and methods. In 200 donors and 50 healthy volunteers (aged from 20 to 60 years old) we analyzed hemostatic parameters: whole blood clotting time, activated partial thromboplastin time, international normalized ratio, platelet aggregation, antithrombin III (AT-III), Claus fibrinogen content, activity of von Willebrand factor (VWF) and factor VIII. The results obtained presented as M ± m. Statistical diff erences by Student test were considered as signifi cant for p < 0,05. Results. All donors had the tendency to hypercoagulation with compensatory activation of anticoagulant system. Depending on the age and number of blood donations, obtained blood components were diff erent in platelet aggregation, AT-III level, fibrinogen content, activity of VWF and factor VIII. Conclusion. Transfusion therapy of coagulopathies can be optimized through the use of blood components purposefully prepared taking into account the nature of blood clotting disorders in the recipient.

Prostacyclin Prevents Endothelial & Platelet Damage During Haemodialysis

1981 ◽  
Author(s):  
J H Turney ◽  
N Dodd ◽  
M J Weston
Keyword(s):  
Cardiovascular Disease ◽  
Factor Viii ◽  
Antithrombin Iii ◽  
Endothelial Damage ◽  
Atherosclerotic Cardiovascular Disease ◽  
Vascular Endothelial ◽  
Blood Components ◽  
Prothrombotic State ◽  
At Iii ◽  
Extracorporeal Circuits

We have previously demonstrated that prostacyclin (PGI) enhances the biocompatibility of extracorporeal circuits. Dialysis with & without PGI were studied in 17 patients. We measured platelet count, (β-thromboglobulin, factor VIII related antigen, & Antithrombin III (Bick method). Results are presented as percentage change + SEM of initial values.The change in all values during dialysis with heparin alone was significant (p<0.005). Additional PGI prevented any change (p<0.0001 compared with heparin at 300 minutes). We conclude that platelet activation & consumption persists throughout dialysis with heparin alone. The rise in factor VIII-RA & AT III reflects vascular endothelial damage induced by the reinfusion of activated blood components. Thus PGI not only protects platelets but also prevents dialysis-induced vascular endothelial damage. Longterm use of PGI should tend to reverse the prothrombotic state in dialysed uraemic patients and may therefore reduce their risk of atherosclerotic cardiovascular disease.

scholarly journals Abnormalities of factor VIII and platelet aggregation--use of ristocetin in diagnosing the von Willebrand syndrome

Blood ◽  
1975 ◽  
Vol 45 (3) ◽  
pp. 403-412 ◽  
Author(s):  
HJ Weiss
Keyword(s):  
Platelet Aggregation ◽  
Factor Viii ◽  
Platelet Rich Plasma ◽  
Second Phase ◽  
Von Willebrand's Disease ◽  
Von Willebrand’S Disease ◽  
Low Concentrations ◽  
Platelet Defects ◽  
Von Willebrand ◽  
Induced Aggregation

Ristocetin was used to study platelet aggregation in platelet-rich plasma and to assay the von Willebrand factor activity of factor VIII (VIII-VWF). Ristocetin-induced platelet aggregation (RIPA) was decreased in 13 of 18 patients with von Willebrand's disease (VWD) who had decreased plasma levels of VIII-VWF. The five patients with normal RIPA appeared to have mild VWD but did not constitute a separate subclass. RIPA was also abnormal in some patients with intrinsic platelet defects, but in no case was the defect corrected by normal plasma. The latter type of correction appears to be specific for VWD. Aspirin ingestion inhibited the second phase of RIPA (at low concentrations of ristocetin only) but did not affect the initial phase of aggregation or the level of VIII-VWF. We also studied a group of patients who had both abnormalities of the factor VIII complex and intrinsic platelet defects, such as impaired collagen-induced aggregation, as well. The findings in these patients and in those with typical von Willebrand's disease appear to comprise a spectrum of disorders (the von Willebrand syndrome) in which some abnormality of the factor VIII complex is associated with impaired platelet function. At present, ristocetin would appear to be a useful reagent for evaluating patients with bleeding disorders and for studying patients with the von Willebrand syndrome.

Intracellular interaction of von Willebrand factor and factor VIII depends on cellular context: lessons from platelet-expressed factor VIII

Blood ◽  
2005 ◽  
Vol 105 (12) ◽  
pp. 4674-4676 ◽  
Author(s):  
Helen Yarovoi ◽  
Alan T. Nurden ◽  
Robert R. Montgomery ◽  
Paquita Nurden ◽  
Mortimer Poncz
Keyword(s):  
Factor Viii ◽  
Von Willebrand Factor ◽  
Blood Clotting ◽  
Immunogold Electron Microscopy ◽  
Bleeding Diathesis ◽  
Cell Type ◽  
Carotid Artery Injury ◽  
Cellular Context ◽  
Von Willebrand ◽  
Willebrand Factor

Abstract We have previously reported that ectopically expressed factor VIII (FVIII) is stored within platelets and is released upon platelet activation. Studies by others in various cell lines have suggested that having von Willebrand factor (VWF) coexpression is necessary for FVIII granular storage and for its secretion. We tested the importance of VWF coexpression for ectopic storage of FVIII in platelets and for its bioavailability. Transgenic mice expressing platelet-specific FVIII were crossed onto a VWF-/- background. Antigenic levels of platelet FVIII in these mice were nearly unchanged whether VWF was present or not. Whole-blood clotting times and FeCl3 carotid artery injury correction demonstrated that platelet FVIII demonstrably improved the bleeding diathesis in FVIIInull mice independent of the platelets' VWF status. Immunogold electron microscopy demonstrated that platelet FVIII is stored in platelet α-granules independent of the presence of VWF. It appears that FVIII's interaction with VWF and its intracellular transportation, storage, and secretion differ greatly depending on the cell type. The molecular basis for these differences now needs to be elucidated. (Blood. 2005;105:4674-4676)

Graded approach for the correction of hemostatic disorders at massive obstetric hemorrhages by blood components considering hemostasis quality of blood donors

2019 ◽  
Author(s):  
А.Ф. Кубиддинов ◽  
М.З. Тагожонов ◽  
Д.С. Саидов ◽  
А.А. Одинаев ◽  
З.Ф. Тагожонов ◽  
...  
Keyword(s):  
Blood Loss ◽  
Blood Clotting ◽  
Individual Selection ◽  
Clotting Factors ◽  
Hemoglobin Content ◽  
Transfusion Therapy ◽  
At Iii ◽  
Hemostatic Disorders ◽  
Blood Clotting Factors ◽  
Selection Of

Цель исследования: улучшение результатов лечения родильниц с массивной кровопотерей за счет индивидуального подбора гемопрепаратов с учетом параметров гемостаза донора и характера коагулопатий у родильниц. Материалы и методы. Исследование включало 2 этапа. На первом этапе изучали параметры гемостаза различных категорий доноров в зависимости от возраста и других факторов. У 200 доноров (100 мужчин и 100 женщин) в возрасте от 18 до 65 лет определяли количество эритроцитов, содержание гемоглобина, время свертывания крови (ВСК) по Ли-Уайту, активированное частичное тромбопластиновое время (АЧТВ), агрегацию тромбоцитов, содержание фибриногена, антитромбина III (АТ-III) и общего белка сыворотки. На втором этапе обследовали 67 родильниц с массивной кровопотерей. Основную группу (ОГ) составили 37 (55,2%) родильниц, которым препараты для трансфузии подбирали в зависимости от характера изменений параметров гемостаза: проводили индивидуальный подбор трансфузионной терапии с учетом показателей гемостаза донора. Контрольную группу (КГ) составили 30 (44,8%) родильниц, которым плазмотрансфузию проводили без учета параметров гемостаза донорской плазмы. У пациенток исследовали количество эритроцитов, содержание гемоглобина, ВСК по Ли-Уайту, АЧТВ, протромбиновое время, международное нормализованное отношение, агрегацию тромбоцитов, концентрацию фибриногена и АТ-III. Результаты. Из крови доноров были получены 3 варианта свежезамороженной плазмы (СЗП): СЗП с нормальным содержанием факторов свертывания крови; СЗП с повышенным содержанием факторов свертывания крови; СЗП с нормальным содержанием факторов свертывания крови и повышенным содержанием факторов противосвертывающей системы. При индивидуальном подборе трансфузионных сред потребность в СЗП у родильниц в ОГ была меньше, чем у родильниц в КГ вне зависимости от причин массивной кровопотери (р < 0,05). Заключение. Предлагаемый способ избирательного подбора донорской плазмы в зависимости от характера нарушений гемостаза у реципиента при возмещении кровопотери в акушерстве дает возможность уменьшить объем переливаемой СЗП; быстрее, чем при традиционной методике нормализуются целевые параметры гемостаза у родильниц; сокращается время проведения инфузионно-трансфузионной терапии; снижается число осложнений; улучшаются результаты лечения родильниц с острой кровопотерей. Aim: to improve the treatment of puerperants with massive blood loss by individual selection of blood products according to parameters of donor’s hemostasis and coagulopathy character in puerperants. Materials and methods. The study included 2 stages. At the fi rst stage, hemostatic parameters in various categories of donors were studied depending on age and other factors. The number of erythrocytes, hemoglobin content, Lee-White blood clotting time (BCT), activated partial thromboplastin time (APTT), platelet aggregation, fi brinogen content, antithrombin III (AT-III) and total serum protein were determined in 200 donors (100 men and 100 women) aged from 18 to 65 years. At the second received individual transfusion therapy that takes into account hemostatic parameters of puerperant and donor. The control group (CG) consisted of 30 (44.8%) puerperants; they received standard transfusion therapy without individual selection of donated plasma. Erythrocyte counts, hemoglobin content, Lee-White BCT, APTT, prothrombin time, international normalized ratio, platelet aggregation, fi brinogen concentration and AT-III were studied in patients. Results. Three types of fresh frozen plasma (FFP) were obtained from donated blood: FFP with normal content of blood clotting factors; FFP with high content of blood clotting factors; FFP with normal content of blood clotting factors and high content of anticoagulative factors. Irrespectively of the causes of massive blood loss, the necessity in FFP for puerperants from MG (with individual selection of transfusion media) was less than for puerperants from CG (p < 0.05). Conclusion. The proposed method of donated plasma selection for blood loss compensation according the character of hemostatic disorders in obstetric patient makes it possible to reduce the volume of transfused FFP; target hemostatic parameters in puerperants normalized faster than with the traditional method; time of infusion-transfusion therapy reduced; the number of complications decreases; treatment results of puerperants with acute blood loss improved.

scholarly journals A factor VIII-derived peptide enables von Willebrand factor (VWF)-binding of artificial platelet nanoconstructs without interfering with VWF-adhesion of natural platelets

Nanoscale ◽  
2014 ◽  
Vol 6 (9) ◽  
pp. 4765-4773 ◽  
Author(s):  
Hassan Haji-Valizadeh ◽  
Christa L. Modery-Pawlowski ◽  
Anirban Sen Gupta
Keyword(s):  
Platelet Aggregation ◽  
Factor Viii ◽  
Von Willebrand Factor ◽  
Mimetic Peptides ◽  
Binding Peptides ◽  
Von Willebrand ◽  
Willebrand Factor

Co-decoration of liposomal nanoconstructs with FVIII-derived VWF-binding-peptides (VBP) and active platelet-clustering fibrinogen-mimetic-peptides (FMP) allows platelet-mimetic VWF-adhesion and platelet aggregation.

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