Liver diseases result in a re-balanced state of the haemostatic system with decreased
haemostatic reserves. Increased fibrinolytic activity is commonly seen during liver
transplants. The aim of this study was to assess whether ClotPro's ECA-test is able
to detect hyperfibrinolysis earlier and with higher frequency than ClotPro's conventional
viscoelastic assays for the intrinsic and the extrinsic coagulation pathway. From
25 liver transplant recipients, systemic blood samples were collected during surgery.
Viscoelastic haemostatic assays with ClotPro's IN-test, EX-test and ECA-test were
performed simultaneously from each blood sample. Hyperfibrinolysis was defined on
the basis of the manufacturer's prespecified threshold value (maximal lysis >15%).
The incidence of hyperfibrinolysis detected with each test was compared with the McNemar
test. For each assay, lysis detection time (LDT) was calculated and analysed with
the nonparametric Kruskal–Wallis test. A total of 125 tests were performed simultaneously.
Compared with the IN-test and the EX-test, the ECA-test detected hyperfibrinolysis
in significantly (P < 0.001) higher number of patients (9; 11; 14, respectively) and
in more measurement points (14; 18; 28, respectively). The analysis of LDT values
revealed significant superiority of the ECA-test to the IN-test (P = 0.046) and to
the EX-test (P = 0.035), indicating the profibrinolytic state of the haemostasis 8.9
± 0.65 and 8.7 ± 0.17 min earlier, respectively. These are preliminary results of
the study NCT0424637. ClotPro's ECA-test appeared to detect fibrinolysis in a higher
number of patients, more frequently, and the mean time of detection was 9 min earlier
than that of the IN-test and the EX-test.
