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A modified microchip-based flow chamber system for evaluating thrombogenicity in patients with thrombocytopenia
Bengo Atari1, Takashi Ito2, Tomoka Nagasato3
1Department of Emergency and Intensive Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Thrombosis Journal
|December 9, 2020
Summary
A modified Total Thrombus-formation Analysis System (T-TAS) effectively assesses thrombotic potential in thrombocytopenic patients. This system correlates with bleeding severity and improves evaluation of platelet transfusion efficacy.
Area of Science:
- Biomedical Engineering
- Hematology
- Intensive Care Medicine
Background:
- Patients in intensive care units (ICUs) with thrombocytopenia face high bleeding risks.
- Conventional hemostatic tests are inadequate for evaluating samples with low platelet counts.
- Assessing thrombogenic potential in thrombocytopenic patients requires specialized analytical conditions.
Purpose of the Study:
- To establish suitable analytical conditions using the Total Thrombus-formation Analysis System (T-TAS) for thrombocytopenic patients.
- To quantitatively assess thrombogenic potential in patients with low platelet counts.
- To investigate the relationship between T-TAS values, bleeding symptoms, and the effects of platelet transfusion.
Main Methods:
- Development of modified T-TAS chips with a 50-μm-deep chamber for low-platelet sample analysis.
- Inclusion of 10 adult ICU patients requiring platelet transfusion, categorized by bleeding severity (major vs. minor).
- Assessment of thrombogenic potential using rotational thromboelastometry, multiplate aggregometry, and the modified T-TAS before and after platelet transfusion.
Main Results:
- The modified 50-μm chip demonstrated higher sensitivity than the conventional 80-μm chip for detecting thrombus formation in low-platelet samples.
- Patients with minor bleeding occluded the modified chip (16.3 ± 3.3 min), while most major bleeding patients did not (P < 0.01).
- T-TAS confirmed recovery of thrombogenic potential post-transfusion, correlating with transfused platelet function, not count. T-TAS showed significant differences between bleeding groups and pre/post-transfusion states.
Conclusions:
- A modified microchip-based flow chamber system for T-TAS was successfully developed.
- This system accurately reflects the hemostatic function in patients with thrombocytopenia.
- The T-TAS provides a sensitive tool for evaluating thrombotic potential and transfusion response in critical care settings.
