{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T13:22:19Z","timestamp":1773408139124,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,2,4]],"date-time":"2015-02-04T00:00:00Z","timestamp":1423008000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":209,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Lab Hematology"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Bleeding symptoms in severe thrombocytopenia range from mild to severe. The aim of this <jats:italic>in vitro<\/jats:italic> study was to improve blood clotting and protect against fibrinolysis in reconstituted severe thrombocytopenia blood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thrombocytopenia [(16\u00a0\u00b1\u00a04)\u00a0\u00d7\u00a010<jats:sup>6<\/jats:sup>\/mL] was created by high\u2010speed centrifugation of normal blood with subsequent mixing plasma with packed cells. The blood samples were subjected to clotting by CaCl<jats:sub>2<\/jats:sub> and tissue factor and to fibrinolysis by the addition of tissue plasminogen activator. Blood was spiked with fibrinogen, activated prothrombin complex concentrate (<jats:styled-content style=\"fixed-case\">FEIBA<\/jats:styled-content>), thrombin activatable fibrinolysis inhibitor (<jats:styled-content style=\"fixed-case\">TAFI<\/jats:styled-content>), or their combinations. To mimic the situation that may occur in patients subjected to massive transfusion of plasma substitutes, blood was diluted by 40% of <jats:styled-content style=\"fixed-case\">TRIS<\/jats:styled-content>\/saline buffer. Clotting time (<jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>), \u03b1\u2010Angle, maximum clot firmness (<jats:styled-content style=\"fixed-case\">MCF<\/jats:styled-content>), and lysis onset time (<jats:styled-content style=\"fixed-case\">LOT<\/jats:styled-content>) were evaluated using rotation thromboelastometry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Spiking thrombocytopenia blood with <jats:styled-content style=\"fixed-case\">FEIBA<\/jats:styled-content> led to reduction of <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>. Fibrinogen and <jats:styled-content style=\"fixed-case\">FEIBA<\/jats:styled-content> enhanced \u03b1\u2010Angle and <jats:styled-content style=\"fixed-case\">MCF<\/jats:styled-content> both in the absence and in the presence of <jats:styled-content style=\"fixed-case\">tPA<\/jats:styled-content>. <jats:styled-content style=\"fixed-case\">LOT<\/jats:styled-content> values were prolonged by <jats:styled-content style=\"fixed-case\">TAFI<\/jats:styled-content> and to less extent by <jats:styled-content style=\"fixed-case\">FEIBA<\/jats:styled-content>. Dilution of thrombocytopenia blood was followed by reduction of \u03b1\u2010Angle and <jats:styled-content style=\"fixed-case\">MCF<\/jats:styled-content> compared to nondiluted blood which partly reversed by either fibrinogen or <jats:styled-content style=\"fixed-case\">FEIBA<\/jats:styled-content> being higher using fibrinogen and <jats:styled-content style=\"fixed-case\">FEIBA<\/jats:styled-content> together. Clot strength was enhanced, and fibrinolysis was inhibited by <jats:styled-content style=\"fixed-case\">TAFI<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The results of this study suggest that combined spiking of blood with fibrinogen and <jats:styled-content style=\"fixed-case\">FEIBA<\/jats:styled-content> may be enough to correct the clot formation disorder in severe thrombocytopenia, whereas in thrombocytopenia and blood dilution, additive inhibition of fibrinolysis may be needed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijlh.12331","type":"journal-article","created":{"date-parts":[[2015,2,4]],"date-time":"2015-02-04T12:17:10Z","timestamp":1423052230000},"page":"521-529","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Rotation thromboelastometry analysis of clot formation and fibrinolysis in severe thrombocytopenia: effect of fibrinogen, activated prothrombin complex concentrate, and thrombin\u2010 activatable fibrinolysis inhibitor"],"prefix":"10.1111","volume":"37","author":[{"given":"B.","family":"Shenkman","sequence":"first","affiliation":[{"name":"National Hemophilia Center Sheba Medical Center Tel\u2010Hashomer Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y.","family":"Einav","sequence":"additional","affiliation":[{"name":"Faculty of Sciences Holon Institute of Technology Holon Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Livnat","sequence":"additional","affiliation":[{"name":"National Hemophilia Center Sheba Medical Center Tel\u2010Hashomer Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I.","family":"Budnik","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology I. 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