{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T03:32:08Z","timestamp":1747193528325,"version":"3.40.5"},"reference-count":18,"publisher":"S. Karger AG","issue":"6","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Digestion"],"published-print":{"date-parts":[[2021]]},"abstract":"<b><i>Introduction:<\/i><\/b> For over 30 years, ascites has been postulated to facilitate fibrinolysis in patients with liver cirrhosis. In contrast to previous research employing conventional coagulation tests, this study aimed to characterize hemostatic interactions between blood and ascites using the rotational thromboelastometry (ROTEM). <b><i>Methods:<\/i><\/b> Blood samples \u2013 pure or mixed with ascites in a ratio of 1:1 \u2013 from cirrhotic patients (<i>n<\/i> = 10) were subjected to ROTEM analysis. In addition, a negative control group was built with cirrhotic patients (<i>n<\/i> = 10) whose blood was mixed with physiologic sodium chloride (0.9% NaCl) solution in a ratio of 1:1. Subsequently, ROTEM measurements were subjected to statistical analysis. <b><i>Results:<\/i><\/b> During ascites challenge, clotting time (CT, measured in seconds) was significantly prolonged in EXTEM (blood: 70.40 \u00b1 20.40 vs. ascites\/blood: 109.8 \u00b1 47.7) and APTEM (blood: 66.50 \u00b1 14.55 vs. ascites\/blood: 138.7 \u00b1 105.8), likely reflecting a dilution effect. However, CT in INTEM remained unchanged, suggesting a sustained intrinsic pathway function. Maximal clot firmness (measured in millimeters) in FIBTEM decreased significantly (blood: 14.70 \u00b1 9.55 vs. ascites\/blood: 6.00 \u00b1 5.66), thus indicating depletion of fibrinogen in ascites. Strikingly, maximum lysis (measured in %) significantly decreased in EXTEM (blood: 9.30 \u00b1 2.79 vs. ascites\/blood: 5.50 \u00b1 2.84), APTEM (blood: 8.50 \u00b1 3.10 vs. ascites\/blood: 5.60 \u00b1 2.88), and INTEM (blood: 7.50 \u00b1 2.27 vs. ascites\/blood: 5.10 \u00b1 3.48). <b><i>Conclusions:<\/i><\/b> ROTEM provided new evidence that ascites may not primarily induce fibrinolysis in cirrhotic patients. This finding seems to be of significant importance for the clinical management of cirrhotic patients experiencing complications, for example, abdominal hemorrhage after liver biopsy or paracentesis; here, replacement of prothrombin complex concentrates and\/or fibrinogen concentrates may prove more beneficial than the use of fresh frozen plasma or antifibrinolytic drugs. <\/jats:p>","DOI":"10.1159\/000513715","type":"journal-article","created":{"date-parts":[[2021,3,29]],"date-time":"2021-03-29T21:06:49Z","timestamp":1617052009000},"page":"854-859","source":"Crossref","is-referenced-by-count":0,"title":["Analysis of Ascites-Challenged Blood in Patients with Liver Cirrhosis Using Rotational Thromboelastometry: How Robust Is the Evidence on Ascites-Attributed Fibrinolysis?"],"prefix":"10.1159","volume":"102","author":[{"given":"Sotiria","family":"Bedreli","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitrios","family":"Eleftheriadis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Jahn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Canbay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fuat","family":"Saner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5179-0327","authenticated-orcid":false,"given":"Antonios","family":"Katsounas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2021,3,18]]},"reference":[{"doi-asserted-by":"publisher","key":"ref1","DOI":"10.1111\/j.1572-0241.2000.03299.x"},{"doi-asserted-by":"publisher","key":"ref2","DOI":"10.1111\/j.1365-2362.1985.tb00162.x"},{"doi-asserted-by":"publisher","key":"ref3","DOI":"10.1016\/0753-3322(93)90084-x"},{"doi-asserted-by":"publisher","key":"ref4","DOI":"10.1016\/0016-5085(92)70030-f"},{"doi-asserted-by":"publisher","key":"ref5","DOI":"10.1097\/00000658-198012000-00008"},{"doi-asserted-by":"publisher","key":"ref6","DOI":"10.1055\/s-0035-1550434"},{"doi-asserted-by":"publisher","key":"ref7","DOI":"10.1159\/000354400"},{"doi-asserted-by":"publisher","key":"ref8","DOI":"10.1136\/gutjnl-2015-309922"},{"doi-asserted-by":"publisher","key":"ref9","DOI":"10.1016\/j.jhep.2015.11.004"},{"doi-asserted-by":"publisher","key":"ref10","DOI":"10.1053\/jhep.2001.22172"},{"doi-asserted-by":"publisher","key":"ref11","DOI":"10.1002\/hep.1840170115"},{"doi-asserted-by":"publisher","key":"ref12","DOI":"10.1016\/0016-5085(95)90342-9"},{"doi-asserted-by":"publisher","key":"ref13","DOI":"10.1111\/j.1572-0241.2001.05298.x"},{"doi-asserted-by":"publisher","key":"ref14","DOI":"10.1046\/j.1365-2044.2002.02603.x"},{"doi-asserted-by":"publisher","key":"ref15","DOI":"10.1177\/089686080502504s09"},{"doi-asserted-by":"publisher","key":"ref16","DOI":"10.1160\/TH12-10-0767"},{"doi-asserted-by":"publisher","key":"ref17","DOI":"10.1016\/j.jhep.2013.01.015"},{"doi-asserted-by":"publisher","key":"ref18","DOI":"10.1038\/s41598-019-40412-0"}],"container-title":["Digestion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/513715","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/513715","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T16:17:28Z","timestamp":1745425048000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000513715"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021]]},"references-count":18,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,11,3]]},"published-print":{"date-parts":[[2021,11,9]]}},"URL":"https:\/\/doi.org\/10.1159\/000513715","archive":["Portico"],"relation":{},"ISSN":["0012-2823","1421-9867"],"issn-type":[{"type":"print","value":"0012-2823"},{"type":"electronic","value":"1421-9867"}],"subject":[],"published":{"date-parts":[[2021]]}}}