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Updated: Feb 5, 2026
13:08
Measurement of Factor V Activity in Human Plasma Using a Microplate Coagulation Assay
Published on: September 9, 2012
19.5K
Factor IX from prothrombin complex concentrate augments low dose tissue factor-triggered thrombin generation in vitro
S Hasan1, E Abuelkasem2, B Williams1
1Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD, USA.
British Journal of Anaesthesia
|September 22, 2018
Summary
Prothrombin complex concentrate (PCC) significantly boosts thrombin generation, especially with factor IX (FIX) and factor VIII (FVIII). Standard dosing may underestimate PCC’s full procoagulant potential.
Area of Science:
- Hematology
- Coagulation Science
- Pharmacology
Background:
- Prothrombin complex concentrate (PCC) is widely used for acquired coagulopathy.
- Current PCC dosing relies on prothrombin time, which doesn't fully capture coagulation factor contributions.
- Factor IX (FIX) within PCC may significantly impact thrombin generation dynamics.
Purpose of the Study:
- To investigate the influence of factor IX (FIX) in prothrombin complex concentrate (PCC) on thrombin generation.
- To analyze the synergistic effects of PCC, FIX, and factor VIII (FVIII) on coagulation.
- To evaluate the impact of hemodilution on PCC's procoagulant activity.
Main Methods:
- Analysis of thrombin generation in normal, FIX-deficient, and warfarinized plasma using PCC.
- Assessment of PCC effects at varying concentrations and in combination with FVIII.
- Evaluation of thrombin generation kinetics, including procoagulant and inhibitory phases, under different conditions including 40% dilution.
Main Results:
- FIX-deficient plasma exhibited markedly reduced peak thrombin generation and endogenous thrombin potential compared to normal plasma.
- PCC addition significantly increased thrombin generation in FIX-deficient plasma.
- Combined FVIII and PCC restored normal thrombin generation, with hemodilution enhancing procoagulant effects by slowing inhibition.
Conclusions:
- Factor IX from PCC substantially enhances tissue factor-activated thrombin generation, particularly with elevated FVIII.
- Hemodilution potentiates the procoagulant effects of FIX and FVIII by modulating enzyme inhibition.
- Prothrombin time-based PCC dosing may not fully reflect its procoagulant capacity due to unmeasured intrinsic pathway factors and antithrombin activity.
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