PhD Scientific Days 2020

Clinical Medicine I. Lectures

Coagulation Profile of Kidney Transplanted Children, Using Rotational Thromboelastometry (ROTEM)

Előadó neve

Dr. Berta, László

Előadó munkahelye

Ist Department of Paediatrics, Semmelweis University, Budapest

Előadó telefonszáma

+36303453066

Előadó e-mail címe

xaid.berta@gmail.com

Az előadás címe

Coagulation Profile of Kidney Transplanted Children, Using Rotational Thromboelastometry (ROTEM)

Szerző(k) neve és munkahelye

László Berta1, Attila Szabó1,2, Kata Kelen1, György Reusz1, Péter Sallay1, Péter Krivácsy1,
1 I. Department of Paediatrics, Semmelweis University, Budapest
2 MTA-SE MTA-SE Pediatrics and Nephrology Research Group, Budapest

Szekció

Clinical Medicine I. Lectures

Language of the presentation

Hungarian

Section, first choice

Clinical Medicine

Section, second choice

Clinical Medicine

Összefoglaló szövege

ROTEM is a worldwide accepted and used procedure in terms of acute blood loss and chronic illnesses which affect coagulation factor production.
Coagulation problems are frequent in chronic kidney disease. On one hand, bleeding occurs in about 50% of patients with end-stage renal disease (ESRD). On the other hand, the risk of venous thromboembolism is also increased in patients with ESRD and following kidney transplantation (KT).
Our goal was to describe the coagulation status in paediatric KT children. Correlation analysis between ROTEM and classic coagulation parameters and evaluating ROTEM parameter differences in normal and kidney transplanted children population.
All patients were randomly selected from the KT patients, treated at the I. Dep. of Paediatrics, Semmelweis University.
Standard laboratory values, classic coagulation parameters (PT-INR, aPTT, TT, fibrinogen, AT) and an extended evaluation of haemostasis by means of ROTEM were measured, which included EXTEM (extrinsic pathway activated), INTEM (intrinsic pathway activated), FIBTEM (fibrin polymerisation) and APTEM (extrinsic activated, with fibrinolysis inhibition) measurements.
18 patients (7 female), with an average age of 14,05 years were included. None of the patients were on antithrombotic therapy. In terms of EXTEM parameters, we have found significantly longer clotting time (CG) 67s/57s (p 0,002), thicker maximum clot firmness 68mm/60 mm (p 0,006), and decreased cloth lysis 97,5%/87% (p 0,002) in the 11 to 16 years KT group compared to the age specific control group. However, only the Clotting time(CT) was significantly prolonged 184s/171s (p 0,008) in this age group, concerning INTEM parameters.
Correlation analysis showed moderate correlation (r 0,5 - 0,7) between INTEM CT, clot formation time, maximal clot firmness (MCF) and APTI, platelets, fibrinogen parameters. Strong correlation (r 0,58 – 0,75) was found between FIBTEM MCF and APTI, fibrinogen. APTEM MCF correlation was more prominent with fibrinogen, compared to the EXTEM MCF (r 0,65 vs. 0,54), but a moderate correlation was found between EXTEM MCF and platelets (r 0,63).
ROTEM parameters are showing good correlation with the classic coagulation parameters. Clot formation via extrinsic or intrinsic pathway activation tends to be slower, but extrinsic activated clot was relatively stronger, compared to the control group.

Additional Information

„SUPPORTED BY THE ÚNKP-19-3-I NEW NATIONAL EXCELLENCE PROGRAM OF THE MINISTRY FOR INNOVATION AND TECHNOLOGY.”
Péter Krivácsy e-mail: peter.krivacsy@gmail.com
Attila Szabó e-mail: szabo.attila@med.semmelweis-univ.hu

Bemutatás módja

Szóbeli

Kind

Szabad

Status

elfogadva

Accepted presentation method

szóbeli

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

4178

Start

11:05

End

11:20

Authors (legacy)

László Berta1, Attila Szabó1,2, Kata Kelen1, György Reusz1, Péter Sallay1, Péter Krivácsy1,
1 I. Department of Paediatrics, Semmelweis University, Budapest
2 MTA-SE MTA-SE Pediatrics and Nephrology Research Group, Budapest