Background

Thrombelastography measures in real time coagulation parameters in whole blood samples. The method serves as a useful point-of-care test to diagnose and manage patients with coagulation disorders. The advantage of thromboelastography is the rapid overview of all phases of coagulation and fibrinolysis. However, this method is limited by the need for immediate testing and difficulty in dissecting the exact mechanism of the dysregulation.

Methods

In this study we aim to modify the method to enable assessment of specific aspects of coagulation, even retrospectively. In particular, we investigated whether thromboelastographic studies can be performed using spike-in experiments from frozen plasma samples to measure fibrinolysis parameters (maximum of lysis, lysis time).

First, fifteen poor platelet plasma samples (PPP) were spiked with three donor samples each. Both SpikeIn and whole blood were measured and compared in Ex-, FIB- and TPA-test in thrombelastography (TE). Additionally, PPP of 20 probands was investigated in TE.

Results

SpikeIn and whole blood are measurable in TE. It was possible to perform thrombelastografic assays with fresh PPP and PPP which has been frozen before. Further experiments are following and we expect to correlate SpikeIn and whole blood samples to allow retrospective diagnosis of defects in fibrinolysis system. Furthermore, supplementary investigations to determine plasminogen activator inhibitor-1-, plasminogen- and thrombin-activatable fibrinolysis inhibitor-activity and lysis timer are performed.

Conclusion

Thrombelastografic assays can be used to investigate ability of the plasma factors in frozen samples to lyse clots. The modified method can be useful for laboratories with no immediate access to thromboelastography to retrospectively analysis the fibrinolysis system in patients with bleeding or thrombosis disorders of unknown origin.

Offenlegung Interessenkonflikt:

Nothing to declare