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We investigated the effects of abelacimab, a novel monoclonal antibody targeting factor XI. We collected whole blood samples into two bags (each 240\u00a0ml, control group: enoxaparin 1.2\u00a0mg, treatment group: enoxaparin 1.2\u00a0mg plus abelacimab 5\u00a0mg) and circulated in a hemodialysis device for up to 3\u00a0h. We performed whole blood aggregation and thromboelastometry at several time points. Time to filter clotting was the primary endpoint. We included 10 volunteers. Each volunteer\u2019s blood was split into two bags (containing enoxaparin +\/- abelacimab) and used simultaneously on two hemodialysis devices. The treatment group\u2019s time to filter clotting was significantly prolonged (treatment: 180\u00a0min, IQR 180\u2013180 vs. control: 120\u00a0min, IQR 97\u2013147, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and the transmembrane pressure was significantly lower at the end of the circuit flow (treatment: 13 mmHg vs. control: 65 mmHg, <jats:italic>p<\/jats:italic>\u2009=\u20090.001). Fibrinogen levels and median platelet counts were preserved. Platelet aggregation was better preserved in the treatment group for ristocetin (<jats:italic>p<\/jats:italic>\u2009=\u20090.015), thrombin receptor activating peptide (<jats:italic>p<\/jats:italic>\u2009=\u20090.015), and arachidonic acid (<jats:italic>p<\/jats:italic>\u2009=\u20090.001). Thromboelastometry showed prolonged clotting times in the treatment group at the end of the experiment (INTEM, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001; HEPTEM, <jats:italic>p<\/jats:italic>\u2009=\u20090.001). Abelacimab prolonged the time to filter clotting in this ex vivo model of hemodialysis. This is an aggressive model due to the frequent re-circulation of blood and a lack of endothelial cells. These data provide support for testing abelacimab in patients on hemodialysis.<\/jats:p>","DOI":"10.1007\/s11239-024-03059-x","type":"journal-article","created":{"date-parts":[[2024,11,16]],"date-time":"2024-11-16T15:44:46Z","timestamp":1731771886000},"page":"1339-1348","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The factor XI\/XIa antibody abelacimab combined with enoxaparin inhibits filter clotting in hemodialysis circuits ex vivo"],"prefix":"10.1007","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3639-0106","authenticated-orcid":false,"given":"Juergen","family":"Grafeneder","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gesche","family":"Langer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2286-1077","authenticated-orcid":false,"given":"Christian","family":"Schoergenhofer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8971-6149","authenticated-orcid":false,"given":"Farsad","family":"Eskandary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5652-7977","authenticated-orcid":false,"given":"Bernd","family":"Jilma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasser","family":"Khder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6774-714X","authenticated-orcid":false,"given":"Katarina D.","family":"Kovacevic Miljevic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,11,16]]},"reference":[{"key":"3059_CR1","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1056\/NEJMoa1105594","volume":"367","author":"JB Olesen","year":"2012","unstructured":"Olesen JB, Lip GY, Kamper AL, Hommel K, Kober L, Lane DA, Lindhardsen J, Gislason GH, Torp-Pedersen C (2012) Stroke and bleeding in atrial fibrillation with chronic kidney disease. 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