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Lysis Timer: a new sensitive tool to diagnose hyperfibrinolysis in liver transplantation

dc.rights.licenseauthentificationen_US
hal.structure.identifierBiologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
dc.contributor.authorROULLET, S.
dc.contributor.authorLABROUCHE, S.
dc.contributor.authorMOUTON, C.
dc.contributor.authorQUINART, A.
dc.contributor.authorNOUETTE-GAULAIN, Karine
dc.contributor.authorLAURENT, C.
hal.structure.identifierBiologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
dc.contributor.authorFREYBURGER, G.
dc.date.accessioned2020-11-10T11:11:57Z
dc.date.available2020-11-10T11:11:57Z
dc.date.issued2019-01
dc.identifier.issn1472-4146en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/12195
dc.description.abstractEnAIMS: Diagnosis of hyperfibrinolysis in orthotopic liver transplantation (OLT) remains challenging. Euglobulin clot lysis time (ECLT) is not adapted to clinical situations. ROTEM is specific but seldom sensitive to hyperfibrinolysis. The Lysis Timer assesses 'Global Fibrinolytic Capacity' in citrated plasma (GFC/LT). GFC/LT associates reagents for in vitro triggering of the clot (thrombin and calcium) and its lysis (tissue-plasminogenactivator (t-PA)), turbidity signal acquisition by the Lysis Timer, and dedicated software converting the digital signal into an optical curve. A visual check of the curves was systematic to ascertain the lysis time values calculated by the software. The primary aim of this prospective observational study was to evaluate the ability of GFC/LT to recognise hyperfibrinolysis during OLT. The secondary aim was to compare its results with ROTEM maximum lysis (EXTEM ML) and with standard laboratory tests. METHODS: Thirty consecutive adult patients undergoing OLT were included (NCT03012633). Standard laboratory tests, ROTEM, GFC/LT, ECLT and fibrinolysis parameters were assayed at five sample times. RESULTS: GFC/LT was correlated with ECLT, plasmin activator inhibitor 1 antigen and activity and t-PA activity (r=0.490, 0.681, 0.643 and -0.359, respectively). Hyperfibrinolysis was defined as ECLT ≤60 min. Receiver operating characteristic curve analysis showed that GFC/LT with a threshold of 31 min detected hyperfibrinolysis with a sensitivity of 0.88 (95% CI 0.73 to 0.96), a specificity of 0.68 (95% CI 0.56 to 0.78) and an area under the curve (AUC) of 0.85 (95% CI 0.74 to 0.94). EXTEM ML \textgreater12% did not detect hyperfibrinolysis (sensitivity 0.38 (95% CI 0.24 to 0.55), specificity 0.95 (95% CI 0.86 to 0.99) and AUC 0.60 (95% CI 0.46 to 0.75)). CONCLUSIONS: GFC/LT recognised hyperfibrinolysis during OLT with a significant agreement with the other tests of fibrinolysis. TRIAL REGISTRATION NUMBER: NCT03012633.
dc.language.isoENen_US
dc.subjectArticle CLINIQUE
dc.title.enLysis Timer: a new sensitive tool to diagnose hyperfibrinolysis in liver transplantation
dc.typeArticle de revueen_US
dc.identifier.doi10.1136/jclinpath-2018-205280en_US
dc.subject.halSciences du Vivant [q-bio]/Médecine humaine et pathologieen_US
dc.identifier.pubmed30282673en_US
bordeaux.journalJournal of Clinical Pathologyen_US
bordeaux.page58–65en_US
bordeaux.volume72en_US
bordeaux.hal.laboratoriesBiologie des maladies cardiovasculaires - U1034en_US
bordeaux.issue1en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.identifierhal-02997939
hal.version1
hal.date.transferred2020-11-10T11:12:01Z
hal.exporttrue
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