{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T14:53:39Z","timestamp":1791557619554,"version":"4.3.4"},"reference-count":50,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background &amp; Aims<\/jats:title>\n                    <jats:p>Conventional laboratory tests do not capture platelet\u2013vessel wall interactions (primary haemostasis) occurring in\u00a0vivo, limiting guidance before invasive procedures. This is relevant in patients with thrombocytopenia, hallmark of advanced cirrhosis. Microfluidic assays may overcome these limitations. The Total Thrombus Analysis System (T\u2010TAS) is a flow chamber that can be adapted for thrombocytopenic samples when equipped with the HD\u2010CHIP. The CirTAS study aimed to assess T\u2010TAS reproducibility and the ability to identify a disease\u2010severity gradient in patients with cirrhosis and thrombocytopenia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Eighty\u2010one patients with cirrhosis and thrombocytopenia were enrolled (20 Child\u2013Pugh A, 41 B\/C and 20 B\/C with bacterial infection). T\u2010TAS measurements were performed using the HD\u2010CHIP. Reproducibility was assessed by intraclass correlation coefficients. Thromboelastometry (ROTEM) parameters were analysed in parallel. Multivariable and piecewise regression analyses were performed to test factors influencing T\u2010TAS parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      T\u2010TAS showed high reproducibility, with intraclass correlation coefficients \u22480.90 for all parameters (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), even in platelet counts &lt;\u200950\u2009\u00d7\u200910\n                      <jats:sup>9<\/jats:sup>\n                      \/L. Thrombus formation under flow declined with worsening clinical status and presence of bacterial infection (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Alongside, ROTEM showed a trend towards hypocoagulability with increasing disease severity and correlated with T\u2010TAS parameters. Platelet count and factor VIII (FVIII) were independent determinants of the most representative T\u2010TAS parameters. Exploratory analyses detected a trend towards a stronger platelet count\u2010T\u2010TAS association at 30\u201350\u2009\u00d7\u200910\n                      <jats:sup>9<\/jats:sup>\n                      \/L.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>T\u2010TAS is reproducible in thrombocytopenic cirrhosis and is associated with reduced thrombus formation alongside disease progression and bacterial infection. Platelet count and FVIII are the main determinants of thrombus formation assessed by T\u2010TAS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70871","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T06:23:08Z","timestamp":1789453388000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["An Automated Microfluidic System for Haemostasis Assessment in Cirrhosis With Thrombocytopenia"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5667-6857","authenticated-orcid":false,"given":"Niccol\u00f2","family":"Bitto","sequence":"first","affiliation":[{"name":"Foundation I.R.C.C.S. Ca\u2019 Granda, Ospedale Maggiore Policlinico Angelo Bianchi Bonomi Hemophilia and Thrombosis Center  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5376-9575","authenticated-orcid":false,"given":"Giulia","family":"Tosetti","sequence":"additional","affiliation":[{"name":"Foundation I.R.C.C.S. Ca\u2019 Granda, Ospedale Maggiore Policlinico, Gastroenterology and Hepatology Division  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1602-2776","authenticated-orcid":false,"given":"Armando","family":"Tripodi","sequence":"additional","affiliation":[{"name":"Foundation I.R.C.C.S. Ca\u2019 Granda, Ospedale Maggiore Policlinico Angelo Bianchi Bonomi Hemophilia and Thrombosis Center  Milan Italy"},{"name":"Foundation Luigi Villa  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5730-4473","authenticated-orcid":false,"given":"Anna","family":"Lecchi","sequence":"additional","affiliation":[{"name":"Foundation I.R.C.C.S. Ca\u2019 Granda, Ospedale Maggiore Policlinico Angelo Bianchi Bonomi Hemophilia and Thrombosis Center  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"La Marca","sequence":"additional","affiliation":[{"name":"Foundation I.R.C.C.S. Ca\u2019 Granda, Ospedale Maggiore Policlinico Angelo Bianchi Bonomi Hemophilia and Thrombosis Center  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lidia","family":"Padovan","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation University of Milan  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6286-6924","authenticated-orcid":false,"given":"Erica","family":"Scalambrino","sequence":"additional","affiliation":[{"name":"Foundation I.R.C.C.S. Ca\u2019 Granda, Ospedale Maggiore Policlinico Angelo Bianchi Bonomi Hemophilia and Thrombosis Center  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0194-3962","authenticated-orcid":false,"given":"Marigrazia","family":"Clerici","sequence":"additional","affiliation":[{"name":"Foundation I.R.C.C.S. Ca\u2019 Granda, Ospedale Maggiore Policlinico Angelo Bianchi Bonomi Hemophilia and Thrombosis Center  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9205-2873","authenticated-orcid":false,"given":"Camilla","family":"Caputo","sequence":"additional","affiliation":[{"name":"Foundation I.R.C.C.S. Ca\u2019 Granda, Ospedale Maggiore Policlinico Angelo Bianchi Bonomi Hemophilia and Thrombosis Center  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Luc\u00e0","sequence":"additional","affiliation":[{"name":"Foundation I.R.C.C.S. Ca\u2019 Granda, Ospedale Maggiore Policlinico, Gastroenterology and Hepatology Division  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Primignani","sequence":"additional","affiliation":[{"name":"Foundation I.R.C.C.S. 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