Abnormal plasma clot formation and fibrinolysis reveal bleeding tendency in patients with partial factor XI deficiency

Blood Advances
Gillian N GidleyAlisa S Wolberg

Abstract

Individuals with factor XI (FXI) deficiency have a variable bleeding risk that cannot be predicted from plasma FXI antigen or activity. This limitation can result in under- or overtreatment of patients and risk of bleeding or thrombosis. Previously, plasma clot fibrinolysis assays showed sensitivity to bleeding tendency in a small cohort of patients with severe FXI deficiency. Here, we determined the ability of plasma clot formation, structure, and fibrinolysis assays to predict bleeding tendency in a larger, independent cohort of patients with severe and partial FXI deficiency. Patients were characterized as nonbleeders or bleeders based on bleeding after tonsillectomy and/or dental extraction before diagnosis of FXI deficiency. Blood was collected in the absence or presence of the contact pathway inhibitor corn trypsin inhibitor (CTI). Clotting was triggered in platelet-poor plasma with tissue factor, CaCl2, and phospholipids in the absence and presence of thrombomodulin or tissue plasminogen activator. Clot formation and fibrinolysis were assessed by turbidity and confocal microscopy. CTI-treated plasmas from bleeders showed significantly reduced clot formation and decreased resistance to fibrinolysis compared with plasmas f...Continue Reading

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May 22, 2020·Expert Review of Hematology·Allison P WheelerDavid Gailani
Oct 2, 2020·Hämostaseologie·Debora Bertaggia CalderaraLorenzo Alberio
Sep 14, 2020·Thrombosis and Haemostasis·Debora Bertaggia CalderaraLorenzo Alberio
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Nov 16, 2021·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Li YuanHeng Zhang

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