CHU Bordeaux, Service d'Anesthésie-Réanimation Pellegrin, Bordeaux, France.
Université de Bordeaux, INSERM U 12-11, Maladies rares: Génétique et Métabolisme, Bordeaux, France.
Thromb Haemost. 2019 Jun;119(6):899-905. doi: 10.1055/s-0039-1685452. Epub 2019 Apr 20.
During liver transplantation (LT), thrombin generation (TG) is altered. The most frequently used assay for TG is the Calibrated Automated Thrombogram (CAT). It is designed for series of plasmas and is semi-automated. Complete automation has led to a new device, the ST-Genesia, enabling quantitative standardized TG evaluation.
The aim of this observational study was to compare the TG results of the CAT and the ST-Genesia on frozen-thawed plasma samples prepared from the blood of LT patients.
Poor platelet plasma aliquots were prepared from blood samples from six LT patients selected to get the whole range of TG and were assessed with CAT (recombinant human tissue factor [TF] concentration 5 pm) and with ST-Genesia Bleedscreen assay (BS, using 'low' recombinant human TF concentration) and Thromboscreen assay (TS, using 'medium' recombinant human TF concentration). The TG parameters studied were: lag time, peak, time to peak, endogenous thrombin potential, velocity index and start tail.
BS and TS did not differ significantly from each other whatever the parameter studied, whereas most of the CAT parameters were significantly different from those obtained with BS and TS. Hierarchical clustering analysis of the different parameters of TG showed three homogeneous groups. One cluster gathered TG quantitative parameters from ST-Genesia. A second cluster gathered all the kinetic parameters. The last cluster isolated the quantitative parameters of CAT.
In patients undergoing LT, TG performed with CAT and with ST-Genesia provided different results, for unknown reasons.
在肝移植 (LT) 期间，凝血酶生成 (TG) 会发生改变。最常用于 TG 的检测方法是 Calibrated Automated Thrombogram (CAT)。它是专为一系列血浆设计的，且为半自动检测。完全自动化则导致了一种新设备，即 ST-Genesia，能够进行定量标准化 TG 评估。
本观察性研究旨在比较 CAT 和 ST-Genesia 对从 LT 患者血液制备的冷冻解冻血浆样本的 TG 结果。
从选择的 6 例 LT 患者的血液样本中制备血小板不良血浆等分试样，使用 CAT（重组人组织因子 [TF] 浓度 5 pm）和 ST-Genesia Bleedscreen assay（BS，使用“低”重组人 TF 浓度）和 Thromboscreen assay（TS，使用“中”重组人 TF 浓度）进行评估。研究的 TG 参数包括：延迟时间、峰值、达峰时间、内源性凝血酶潜能、速度指数和起始尾部。
BS 和 TS 之间无论研究的参数如何均无显著差异，而 CAT 的大多数参数与 BS 和 TS 之间有显著差异。TG 不同参数的层次聚类分析显示出三个均匀的组。一个聚类聚集了 ST-Genesia 的 TG 定量参数。第二个聚类聚集了所有动力学参数。最后一个聚类分离了 CAT 的定量参数。
在接受 LT 的患者中，使用 CAT 和 ST-Genesia 进行 TG 检测会提供不同的结果，原因不明。
