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Oglesby IK, Slattery D, Glynn N, Gupta S, Duggan K, Cuesta M, Dunne E, Garrahy A, Toner S, Kenny D, Agha A. The modulation of platelet function by growth hormone in growth hormone deficient Hypopituitary patients. BMC Endocr Disord 2023; 23:197. [PMID: 37705005 PMCID: PMC10500895 DOI: 10.1186/s12902-023-01448-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 08/31/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Growth hormone deficiency (GHD) has been implicated in increased cardiovascular and cerebrovascular disease risk seen in hypopituitarism, however the mechanism remains speculative. We hypothesise that platelet abnormalities may play a contributory role. Herein we examined platelet behaviour in GHD hypopituitary patients, pre- and post-growth hormone (GH) replacement. METHODS This study utilizes a physiological flow-based assay to quantify platelet function in whole blood from patient cohorts under arterial shear. Thirteen GH Naïve hypopituitary adults with GHD and thirteen healthy matched controls were studied. Patients were assessed before and after GH treatment. All other pituitary replacements were optimised before the study. In addition to a full endocrine profile, whole blood was labelled and perfused over immobilised von Willibrand factor (vWF). Seven parameters of dynamic platelet-vWF interactions were recorded using digital image microscopy and analysed by customised platelet tracking software. RESULTS We found a significantly altered profile of platelet-vWF interactions in GHD individuals compared to healthy controls. Specifically, we observed a marked increase in platelets shown to form associations such as tethering, rolling and adherence to immobilized vWF, which were reduced post GH treatment. Speed and distance platelets travelled across vWF was similar between controls and pre-therapy GHD patients, however, this was considerably increased post treatment. This may indicate reduced platelet signaling resulting in less stable adhesion of platelets post GH treatment. CONCLUSIONS Taken together observed differences in platelet behaviour may contribute to an increased risk of thrombosis in GHD which can in part be reversed by GH therapy.
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Affiliation(s)
- Irene K Oglesby
- Irish Centre for Vascular Biology and Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - David Slattery
- Department of Endocrinology, Beaumont Hospital, Dublin 9, Dublin, Ireland
| | - Nigel Glynn
- Department of Endocrinology, Beaumont Hospital, Dublin 9, Dublin, Ireland
| | - Saket Gupta
- Department of Endocrinology, Beaumont Hospital, Dublin 9, Dublin, Ireland
| | - Karen Duggan
- Department of Endocrinology, Beaumont Hospital, Dublin 9, Dublin, Ireland
| | - Martin Cuesta
- Department of Endocrinology, Beaumont Hospital, Dublin 9, Dublin, Ireland
| | - Eimear Dunne
- Irish Centre for Vascular Biology and Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Aoife Garrahy
- Department of Endocrinology, Beaumont Hospital, Dublin 9, Dublin, Ireland
| | - Siobhan Toner
- Department of Endocrinology, Beaumont Hospital, Dublin 9, Dublin, Ireland
| | - Dermot Kenny
- Irish Centre for Vascular Biology and Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Amar Agha
- Department of Endocrinology, Beaumont Hospital, Dublin 9, Dublin, Ireland.
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2
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Ward J, Dunne E, Schoen I, Boyd AR, Kenny D, Meenan BJ. Nanotopography of Polystyrene/Poly(methyl methacrylate) for the Promotion of Patient Specific Von Willebrand Factor Entrapment and Platelet Adhesion in a Whole Blood Microfluidic Assay. Polymers (Basel) 2023; 15:polym15061580. [PMID: 36987359 PMCID: PMC10054393 DOI: 10.3390/polym15061580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/10/2023] [Accepted: 03/19/2023] [Indexed: 03/30/2023] Open
Abstract
Platelet function testing is essential for the diagnosis of patients with bleeding disorders. Specifically, there is a need for a whole blood assay that is capable of analysing platelet behaviour in contact with a patient-specific autologous von Willebrand factor (vWF), under physiologically relevant conditions. The creation of surface topography capable of entrapping and uncoiling vWF for the support of subsequent platelet adhesion within the same blood sample offers a potential basis for such an assay. In this study, spin coating of polystyrene/poly (methyl methacrylate) (PS/PMMA) demixed solutions onto glass substrates in air has been used to attain surfaces with well-defined topographical features. The effect of augmenting the PS/PMMA solution with uniform 50 µm PS microspheres that can moderate the demixing process on the resultant surface features has also been investigated. The topographical features created here by spin coating under ambient air pressure conditions, rather than in nitrogen, which previous work reports, produces substrate surfaces with the ability to entrap vWF from flowing blood and facilitate platelet adhesion. The direct optical visualisation of fluorescently-labelled platelets indicates that topography resulting from inclusion of PS microspheres in the PS/PMMA spin coating solution increases the total number of platelets that adhere to the substrate surface over the period of the microfluidic assay. However, a detailed analysis of the adhesion rate, mean translocating velocity, mean translocation distance, and fraction of the stably adhered platelets measured during blood flow under arterial equivalent mechanical shear conditions indicates no significant difference for topographies created with or without inclusion of the PS microspheres.
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Affiliation(s)
- Joanna Ward
- Nanotechnology and Integrated Bioengineering Centre (NIBEC), School of Engineering, Ulster University, York Street, Belfast BT15 1AP, UK
| | - Eimear Dunne
- Irish Centre for Vascular Biology, Royal College of Surgeons in Ireland, 123 St Stephen's Green, D02 YN77 Dublin, Ireland
| | - Ingmar Schoen
- Irish Centre for Vascular Biology, Royal College of Surgeons in Ireland, 123 St Stephen's Green, D02 YN77 Dublin, Ireland
| | - Adrian R Boyd
- Nanotechnology and Integrated Bioengineering Centre (NIBEC), School of Engineering, Ulster University, York Street, Belfast BT15 1AP, UK
| | - Dermot Kenny
- Irish Centre for Vascular Biology, Royal College of Surgeons in Ireland, 123 St Stephen's Green, D02 YN77 Dublin, Ireland
| | - Brian J Meenan
- Nanotechnology and Integrated Bioengineering Centre (NIBEC), School of Engineering, Ulster University, York Street, Belfast BT15 1AP, UK
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3
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Li N, Liu Y, Yun A, Song S. Correlation of Platelet Function with Postpartum Hemorrhage and Venous Thromboembolism in Patients with Gestational Hypertension Complicated with Diabetes. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:2423333. [PMID: 35898483 PMCID: PMC9313953 DOI: 10.1155/2022/2423333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/31/2022] [Accepted: 06/07/2022] [Indexed: 11/25/2022]
Abstract
Objective This study was aimed at investigating the correlation of platelet function with postpartum hemorrhage and venous thromboembolism (VTE) in gestational hypertension patients with diabetes mellitus. Methods A total of 93 patients with gestational hypertension complicated with diabetes treated from March 2020 to June 2021 were selected as the research group, and 56 healthy pregnant women during the same period were selected as the control group. Platelet function-related indicators (platelet count (PLT), platelet volume distribution width (PDW), and mean platelet volume (MPV)) were compared between the two groups. The patients were divided into a severe group (n = 13), mild group (n = 28), and nonbleeding group (n = 52) according to the severity of postpartum hemorrhage, and the value of combined detection of platelet function-related indicators on the severity of postpartum hemorrhage was evaluated and analyzed. According to the occurrence of VTE, the patients were divided into a VTE group and non-VTE group to analyze the predictive value of combined detection of platelet function-related indicators for VTE occurrence in patients. Results The PLT value of the study group was lower than that of the control group, while the PDW and MPV values were higher than those of the control group (all P < 0.05). The PLT value increased with the aggravation of postpartum hemorrhage, while the PDW and MPV values decreased with the aggravation of postpartum hemorrhage among the three groups with different severities of postpartum hemorrhage (all P < 0.05). The area under the curve (AUC) of PLT, PDW, and MPV combination to evaluate the severity of postpartum hemorrhage in patients with gestational hypertension combined with diabetes was greater than that of PLT alone and PDW alone (both P < 0.05). The PLT value was negatively correlated with the severity of postpartum hemorrhage, while PDW and MPV values were positively correlated with the severity of postpartum hemorrhage (both P < 0.05). According to the occurrence of VTE, patients were divided into the VTE group (n = 10) and non-VTE group (n = 83). The PLT value of the VTE group was higher than that of the non-VTE group, while the PDW and MPV values were lower than those of the non-VTE group (all P < 0.05). The AUC of PLT, PDW, and MPV combination to predict the occurrence of VTE in patients with gestational hypertension combined with diabetes was greater than that of each index alone (all P < 0.05). Conclusion Patients with gestational hypertension complicated with diabetes had abnormal platelet function, and the platelet function was related to postpartum hemorrhage and VTE.
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Affiliation(s)
- Nan Li
- Department of Obstetrics, The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, Tianjin 300170, China
- Department of Obstetrics, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin 300170, China
- Department of Obstetrics, Artificial Cell Engineering Technology Research Center, Tianjin 300170, China
- Department of Obstetrics, Tianjin Institute of Hepatobiliary Disease, Tianjin 300170, China
| | - Yang Liu
- Department of Obstetrics, The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, Tianjin 300170, China
- Department of Obstetrics, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin 300170, China
- Department of Obstetrics, Artificial Cell Engineering Technology Research Center, Tianjin 300170, China
- Department of Obstetrics, Tianjin Institute of Hepatobiliary Disease, Tianjin 300170, China
| | - Anqi Yun
- Department of Obstetrics, The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, Tianjin 300170, China
- Department of Obstetrics, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin 300170, China
- Department of Obstetrics, Artificial Cell Engineering Technology Research Center, Tianjin 300170, China
- Department of Obstetrics, Tianjin Institute of Hepatobiliary Disease, Tianjin 300170, China
| | - Shurong Song
- Department of Obstetrics, The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, Tianjin 300170, China
- Department of Obstetrics, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin 300170, China
- Department of Obstetrics, Artificial Cell Engineering Technology Research Center, Tianjin 300170, China
- Department of Obstetrics, Tianjin Institute of Hepatobiliary Disease, Tianjin 300170, China
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4
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Recombinant vs plasma-derived von Willebrand factor to prevent postpartum hemorrhage in von Willebrand disease. Blood Adv 2021; 4:3234-3238. [PMID: 32692849 DOI: 10.1182/bloodadvances.2020002046] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 06/25/2020] [Indexed: 01/03/2023] Open
Abstract
von Willebrand disease (VWD) is a congenital bleeding disorder characterized by deficient or defective von Willebrand factor (VWF). Among women with VWD, postpartum hemorrhage (PPH) is common. Treatment options at delivery include plasma-derived VWF (pdVWF) and recombinant VWF (rVWF). However, limited data are available regarding their efficacy. We conducted a retrospective observational study comparing PPH in women with VWD treated at the Hemophilia Center of Western Pennsylvania between 1 February 2017 and 31 January 2018 with either rVWF or pdVWF. We compared postpartum outcomes, including PPH frequency and estimated blood loss (EBL) at delivery. There were a total of 12 deliveries, 7 vaginal and 5 cesarean. At delivery and for 3 days postpartum, 6 women received 80 IU/kg of rVWF and 6 received 80 IU/kg of pdVWF, based on prepregnancy weight, insurance, and/or patient choice. Treatment groups had similar demographics, including median age (32.0 vs 27.0 years; P = .075), bleeding scores (3.0 vs 3.5; P = .734), and prepregnancy body mass index (29.0 vs 29.2 kg/m2; P = .691). PPH occurred in 3 (25.0%) of 12 deliveries, with no difference by treatment group (2 of 6 rVWF vs 1 of 6 pdVWF; P = 1.000) and no difference in EBL by treatment group (685 vs 462 mL; P = .384) or delivery type (vaginal, P = .722 vs cesarean, P = .531). In summary, PPH occurred in one-fourth of the deliveries in women with VWD, despite a higher dose (80 IU/kg) of rVWF or pdVWF. Future trials are needed to develop and assess novel strategies to prevent PPH in VWD.
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5
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de Jong W, Asmarawati TP, Verbeek I, Rusli M, Hadi U, van Gorp E, Goeijenbier M. Point-of-care thrombocyte function testing using multiple-electrode aggregometry in dengue patients: an explorative study. BMC Infect Dis 2020; 20:580. [PMID: 32762658 PMCID: PMC7409667 DOI: 10.1186/s12879-020-05248-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 07/14/2020] [Indexed: 12/13/2022] Open
Abstract
Background Dengue virus (DENV) causes the hospitalisation of an estimated 500,000 people every year. Outbreaks can severely stress healthcare systems, especially in rural settings. It is difficult to discriminate patients who need to be hospitalized from those that do not. Earlier work identified thrombocyte count and subsequent function as a promising prognostic marker of DENV severity. Herein, we investigated the potential of quantitative thrombocyte function tests in those admitted in the very early phase of acute DENV infections, using Multiplate™ multiple-electrode aggregometry to explore its potential in triage. Methods In this prospective cohort study all patients aged ≥13 admitted to Universitas Airlangga Hospital in Surabaya, Indonesia with a fever (≥38 °C) between 25 January and 1 August 2018 and with a clinical suspicion of DENV, were eligible for inclusion. Exclusion criteria were a thrombocyte count below 100 × 109/L and the use of any medication with a known anticoagulant effect, nonsteroidal anti-inflammatory drugs and acetyl salicylic acid. Clinical data was collected and blood was taken on admission, day 1 and day 7. Samples were tested for acute DENV, using Panbio NS1 ELISA. Platelet aggregation using ADP-, TRAP- and COL-test were presented as Area Under the aggregation Curve (AUC). Significance was tested between DENV+, probably DENV, fever of another origin, and healthy controls (HC). Results A total of 59 patients (DENV+ n = 10, DENV probable n = 25, fever other origin n = 24) and 20 HC were included. We found a significantly lower thrombocyte aggregation in the DENV+ group, compared with both HCs and the fever of another origin group (p < .001). Low ADP AUC values on baseline correlated to a longer hospital stay in DENV+ and probable DENV cases. Conclusion Thrombocyte aggregation induced by Adenosine diphosphate, Collagen and Thrombin receptor activating peptide-6 is impaired in human DENV cases, compared with healthy controls and other causes of fever. This explorative study provides insights to thrombocyte function in DENV patients and could potentially serve as a future marker in DENV disease.
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Affiliation(s)
- Wesley de Jong
- Department of Viroscience, Erasmus MC, Rotterdam, the Netherlands.
| | - Tri Pudy Asmarawati
- Department of Internal Medicine, Universitas Airlangga Hospital, Airlangga University, Surabaya, Indonesia
| | - Inge Verbeek
- Department of Viroscience, Erasmus MC, Rotterdam, the Netherlands
| | - Musofa Rusli
- Department of infectious diseases, Rumah Sakit Umum Daerah Dr Soetomo, Airlangga University, Surabaya, Indonesia
| | - Usman Hadi
- Department of infectious diseases, Rumah Sakit Umum Daerah Dr Soetomo, Airlangga University, Surabaya, Indonesia
| | - Eric van Gorp
- Department of Viroscience, Erasmus MC, Rotterdam, the Netherlands.,Department of internal medicine, Erasmus MC, Rotterdam, the Netherlands
| | - Marco Goeijenbier
- Department of Viroscience, Erasmus MC, Rotterdam, the Netherlands. .,Department of internal medicine, Erasmus MC, Rotterdam, the Netherlands.
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6
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Ragni MV. Case-based discussion on the implications of exogenous estrogens in hemostasis and thrombosis: the hematologist's view. HEMATOLOGY. AMERICAN SOCIETY OF HEMATOLOGY. EDUCATION PROGRAM 2019; 2019:152-157. [PMID: 31808846 PMCID: PMC6913423 DOI: 10.1182/hematology.2019000022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In the childbearing years, hormonal therapy or hormonal changes in the menstrual cycle or the puerperium may be complicated by bleeding or thrombosis; however, among women with congenital disorders of hemostasis and thrombosis, the risk of bleeding or thrombosis may be increased. In women with congenital bleeding disorders, heavy menstrual bleeding is the most common bleeding symptom, and postpartum hemorrhage occurs despite treatment. Given the limitations of current therapy and the associated medical and psychological burden in women with bleeding disorders, better treatment approaches are needed to improve health outcomes and quality of life. In women with congenital thrombotic disorders, thromboembolism may complicate exogenous hormonal therapy and endogenous hormonal change during pregnancy and procedures, but risk differs by type of thrombophilia, procedure, time at risk, and thrombosis risk factors, all of which affect management. In this article, I shall consider a case-based discussion of current issues in women with congenital bleeding and clotting disorders, including heavy menstrual bleeding in a woman with VWD, postpartum hemorrhage risk in VWD, and thrombosis risk with oocyte retrieval in a woman with factor V Leiden and past thromboembolism. The goals are to review bleeding or thrombosis risk in these cases, current data, limitations of current treatment guidelines, and areas for future study.
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Affiliation(s)
- Margaret V Ragni
- Department of Medicine, Division of Hematology/Oncology and Hemophilia Center of Western Pennsylvania, University of Pittsburgh, Pittsburgh, PA
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7
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Blood group alters platelet binding kinetics to von Willebrand factor and consequently platelet function. Blood 2019; 133:1371-1377. [PMID: 30642918 DOI: 10.1182/blood-2018-06-855528] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 01/03/2019] [Indexed: 01/29/2023] Open
Abstract
Blood type O is associated with a lower risk of myocardial infarction. Platelets play a critical role in myocardial infarction. It is not known whether the expression of blood group antigens on platelet proteins alters platelet function; we hypothesized that platelet function would be different between donors with blood type O and those with non-O. To address this hypothesis, we perfused blood from healthy type O donors (n = 33) or non-O donors (n = 54) over pooled plasma derived von Willebrand factor (VWF) protein and purified blood type-specific VWF at arterial shear and measured platelet translocation dynamics. We demonstrate for the first time that type O platelets travel farther at greater speeds before forming stable bonds with VWF. To further characterize these findings, we used a novel analytical model of platelet interaction. Modeling revealed that the kinetics for GPIb/VWF binding rate are significantly lower for type O compared with non-O platelets. Our results demonstrate that platelets from type O donors interact less with VWF at arterial shear than non-O platelets. Our results suggest a potential mechanism for the reduced risk of myocardial infarction associated with blood type O.
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8
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Cowman J, Richter L, Walsh R, Keegan N, Tinago W, Ricco AJ, Hennessy BT, Kenny D, Dunne E. Dynamic platelet function is markedly different in patients with cancer compared to healthy donors. Platelets 2018; 30:737-742. [PMID: 30252557 DOI: 10.1080/09537104.2018.1513475] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Despite a fivefold increased risk of thromboembolism in patients with cancer, the mechanism of arterial thromboembolism is poorly understood. To address this, we investigated platelet function in cancer patients and healthy controls using an assay that mimics the arterial vasculature. Blood samples from cancer patients (n = 36) and healthy controls (n = 22) were perfused through custom-made parallel-plate flow chambers coated with von Willebrand factor (VWF) under arterial shear (1,500 s-1). Multiparameter measurements of platelet interactions with the immobilized VWF surface were recorded by digital-image microscopy and analyzed using custom-designed platelet-tracking software. Six measured parameters that characterize in detail the surface motion and surface binding of several hundred platelets per blood sample differed significantly in those with cancer from the healthy donors. In particular, it was found that patients with cancer had decreased numbers of platelets interacting, translocating and adhering to VWF. There were also reductions in the speed and distances that platelets traveled on VWF in comparison to healthy controls. Platelet function differed between those with early-stage cancer compared to those with later stage cancer. Patients with advanced cancer had an increased number of platelets stably adhering to VWF and greater platelet surface coverage after a given time of interaction. To the best of our knowledge, our results demonstrate for the first time that dynamic platelet function is markedly different in patients with cancer compared to healthy donors.
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Affiliation(s)
- Jonathan Cowman
- a Molecular and Cellular Therapeutics , The Royal College of Surgeons in Ireland , Dublin , Ireland
| | - Louis Richter
- a Molecular and Cellular Therapeutics , The Royal College of Surgeons in Ireland , Dublin , Ireland
| | - Roisin Walsh
- a Molecular and Cellular Therapeutics , The Royal College of Surgeons in Ireland , Dublin , Ireland
| | - Niamh Keegan
- b Department of Medical Oncology , Beaumont Hospital , Dublin , Ireland
| | - Willard Tinago
- c HIV Molecular Research Group , University College Dublin , Dublin , Ireland
| | - Antonio J Ricco
- d The Biomedical Diagnostics Institute, Dublin City University , Dublin , Ireland
| | - Bryan T Hennessy
- b Department of Medical Oncology , Beaumont Hospital , Dublin , Ireland
| | - Dermot Kenny
- a Molecular and Cellular Therapeutics , The Royal College of Surgeons in Ireland , Dublin , Ireland
| | - Eimear Dunne
- a Molecular and Cellular Therapeutics , The Royal College of Surgeons in Ireland , Dublin , Ireland
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9
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Kennedy C, Wong L, Sexton DJ, Cowman J, Oglesby I, Kenny M, Conlon PJ, Kenny D. Successful kidney transplantation normalizes platelet function. Clin Kidney J 2018; 11:574-580. [PMID: 30087773 PMCID: PMC6070122 DOI: 10.1093/ckj/sfx148] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 11/27/2017] [Indexed: 12/23/2022] Open
Abstract
Background Uraemic platelet dysfunction is not completely understood, in part due to non-physiological platelet function assays. We have developed a physiological flow-based assay that quantifies platelet function in microlitre volumes of blood under arterial shear. The aim of this study was to characterize platelet function before and after kidney transplantation. Methods Ten patients scheduled for living donor kidney transplant surgery and nine healthy controls were analysed using the assay. The motional parameters of platelet behaviour on von Willebrand factor (VWF) were recorded using customized platelet tracking software. The assay was repeated 3–8 weeks post-transplant in the transplant group and at an interval of >3 weeks in normal healthy volunteers. Results Platelet–VWF interactions were markedly reduced in the 10 pre-transplant patients compared with the healthy controls. In seven patients with immediate graft function, dynamic platelet function returned to normal (despite a small decrease in haemoglobin and haematocrit), but remained markedly abnormal in the three patients with delayed graft function (DGF). Conclusions Dynamic platelet function returned to normal following transplantation in those with immediate graft function. This early improvement was not observed in those with DGF. There may be important clinical implications, as patients with DGF are more likely to undergo invasive procedures, including transplant biopsies and insertion of central venous catheters.
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Affiliation(s)
- Claire Kennedy
- Department of Nephrology, Beaumont Hospital, Dublin, Ireland.,Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Limy Wong
- Department of Nephrology, Beaumont Hospital, Dublin, Ireland
| | - Donal J Sexton
- Department of Nephrology, Beaumont Hospital, Dublin, Ireland
| | - Jonathan Cowman
- Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland.,Irish Centre for Vascular Biology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Irene Oglesby
- Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Martin Kenny
- Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Peter J Conlon
- Department of Nephrology, Beaumont Hospital, Dublin, Ireland.,Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Dermot Kenny
- Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland.,Irish Centre for Vascular Biology, Royal College of Surgeons in Ireland, Dublin, Ireland
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