THROMBUS GENERATION UNDER FLOW CONDITIONS IN PATIENTS WITH CIRRHOSIS AND THROMBOCYTOPENIA: THE CIRTAS-STUDY
type: CreativeWork
description: Background: Thrombocytopenia is a hallmark of cirrhosis, however its effect on the bleeding risk remains uncertain due to a rebalance of hemostasis. Traditional coagulation tests, such as platelet count, prothrombin and activated thromboplastin time, fail to capture the complex interplay of pro- and anti-hemostatic mechanisms and do not reliably predict the bleeding risk in cirrhosis. Global hemostasis assays, including thromboelastometry and thrombin generation, are valid alternatives, however, despite their relevant contribution to understand the complexity of hemostasis in advanced chronic liver disease, they are not recommended for the bleeding risk stratification in clinical practice. An automatized microfluidic system based on a dedicated chip, the Total Thrombus Analysis System (T-TAS®) with HD-CHIP, is a new laboratory tool to assess the thrombus formation under flow in patients with thrombocytopenia, but has never been tested in cirrhosis. Aims: We assessed the reproducibility and accuracy of the Total Thrombus Analysis System (T-TAS®) with HD-CHIP in cirrhotic patients with thrombocytopenia with different clinical stages of severity. Additionally, we compared hemostatic parameters in patients stratified for the threshold of 50,000/mm3 platelet and finally evaluated the clinical and laboratory factors influencing thrombus formation. Methods: Thrombus formation was assessed by using the HD-CHIP of T-TAS®, which analyzes the progressive occlusion of a microchannel coated with tissue factor and type I collagen under flow measured as occlusion start time (OST), occlusion time (OT), and area under the curve (AUC). All analyses were duplicated to measure the reproducibility of the test through the intraclass correlation coefficients (ICC), and Bland-Altman plot. Additional assessments included thrombin generation, thromboelastometry, and markers of inflammation and primary and secondary hemostasis. Linear regression models were used to explore the independent cli…
abstract: Background: Thrombocytopenia is a hallmark of cirrhosis, however its effect on the bleeding risk remains uncertain due to a rebalance of hemostasis. Traditional coagulation tests, such as platelet count, prothrombin and activated thromboplastin time, fail to capture the complex interplay of pro- and anti-hemostatic mechanisms and do not reliably predict the bleeding risk in cirrhosis. Global hemostasis assays, including thromboelastometry and thrombin generation, are valid alternatives, however, despite their relevant contribution to understand the complexity of hemostasis in advanced chronic liver disease, they are not recommended for the bleeding risk stratification in clinical practice. An automatized microfluidic system based on a dedicated chip, the Total Thrombus Analysis System (T-TAS®) with HD-CHIP, is a new laboratory tool to assess the thrombus formation under flow in patients with thrombocytopenia, but has never been tested in cirrhosis. Aims: We assessed the reproducibility and accuracy of the Total Thrombus Analysis System (T-TAS®) with HD-CHIP in cirrhotic patients with thrombocytopenia with different clinical stages of severity. Additionally, we compared hemostatic parameters in patients stratified for the threshold of 50,000/mm3 platelet and finally evaluated the clinical and laboratory factors influencing thrombus formation. Methods: Thrombus formation was assessed by using the HD-CHIP of T-TAS®, which analyzes the progressive occlusion of a microchannel coated with tissue factor and type I collagen under flow measured as occlusion start time (OST), occlusion time (OT), and area under the curve (AUC). All analyses were duplicated to measure the reproducibility of the test through the intraclass correlation coefficients (ICC), and Bland-Altman plot. Additional assessments included thrombin generation, thromboelastometry, and markers of inflammation and primary and secondary hemostasis. Linear regression models were used to explore the independent cli…
author: BITTO, NICCOLO
language: eng
keywords: cirrhosis, coagulopathy, von willebrand factor, microfluidics, thrombocytopenia, Settore MEDS-05/A - Medicina interna
date published: 2025-06-18
date modified: 2026-07-27T20:18:58Z
provider: Università degli Studi di Milano
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: Università degli Studi di Milano

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property ID: Handle
value: https://hdl.handle.net/2434/1169944