International pediatric thrombosis network to advance pediatric thrombosis research: Communication from the ISTH SSC subcommittee on pediatric and neonatal thrombosis and hemostasis

Abstract

Pediatric thromboembolism is a rare and heterogenous disease. As a result, there is a paucity of knowledge with regard to natural history, management, and outcomes of most types of pediatric venous and arterial thromboembolism. International research collaboration is needed to fill these knowledge gaps. Not only randomized controlled trials, but also representative observational studies are required to answer all research questions. Therefore, the ISTH SSC Subcommittee on Pediatric and Neonatal Thrombosis and Hemostasis initiated the International Pediatric Thrombosis Network (IPTN). The aims of the IPTN include (1) development of the Throm‐PED registry to facilitate international prospective observational studies, and (2) establishment of a network of pediatric thrombosis centers experienced in effectively conducting clinical trials and observational studies. The IPTN needs dedicated clinicians all over the world and several funding sources to obtain high‐quality research data to reach its ultimate goal of improving care in children with thrombosis. The aim of this communication is to call for active participation in the IPTN to all physicians taking care of children with thrombosis worldwide.

Clinical value of pediatric sepsis‐induced coagulopathy score in diagnosis of sepsis‐induced coagulopathy and prognosis in children

“…The reason may be that the characteristics of coagulation in children differ from those in adults and the risk of thrombosis is low. ISTH SSC subcommittees on pediatric and neonatal thrombosis and hemostasis recently launched the International Pediatric Thrombosis Network 26 to facilitate international prospective observational studies and establish a network of pediatric thrombosis centers experienced in effectively conducting clinical trials and observational studies. Percent lysis at 30 min (LY30) had no differences in CCTs and TEG between the two groups.…”

Clinical Efficacy of Soluble Thrombomodulin, Tissue Plasminogen Activator Inhibitor complex, Thrombin-Antithrombin complex,α2-Plasmininhibitor-Plasmin complex in Pediatric Sepsis

“…The physiological coagulation status in children is more likely to encompass a mild hypercoagulable state than in adults, 37 and children's thrombotic diseases are more often ignored than those of adults. 38 Studies have shown that FDPs and D-dimers are significantly increased during immunothrombosis, 39 but the increase observed in CCTs lacks specificity as these indices are also increased in trauma, tumor, infection, and other diseases; 40 thus, they cannot fully reflect the changes caused by abnormal fibrinolysis in sepsis. The accuracy of FDPs and D-dimers in evaluating the damage to the fibrinolytic system in sepsis has therefore been questioned.…”

Results of an international survey on adherence with anticoagulation in children, adolescents, and young adults: Communication from the ISTH SSC Subcommittee on Pediatric and Neonatal Thrombosis and Hemostasis

“…Based on the results of the survey and prior literature, the next steps for the ISTH SSC on Pediatric/Neonatal Thrombosis and Hemostasis Anticoagulation Adherence Working Group may include to: Engage the International Pediatric Thrombosis Network (IPTN) 31 and other pediatric thrombosis consortia/investigators groups for research in this field including research priorities identified in the 2018 ASH guidelines. Develop validated measures for anticoagulation adherence assessment for all anticoagulants prescribed to children. Evaluate and compare the impact of anticoagulation type (VKA, LMWH/DOAC) on anticoagulation adherence. Study the relationship between anticoagulation adherence and adverse health outcomes. Develop and disseminate ISTH guidelines and standards for how anticoagulation should be monitored, and adherence assessed, in future clinical trials of anticoagulants. Identify resources to support specialized anticoagulation clinics in the measurement of adherence and gather data to support impact. Include other disciplines involved in anticoagulation management in future research. …”

“…1. Engage the International Pediatric Thrombosis Network (IPTN) 31 and other pediatric thrombosis consortia/investigators groups for research in this field including research priorities identified in the 2018 ASH guidelines.…”