The blood coagulation mechanisms in thrombocytopenic blood

Sa, Johnson; Mj, Caldwell; Rw, Monto

doi:10.1055/s-0038-1656211

Cited by 4 publications

(2 citation statements)

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“…or less) is not due to residual prothrombin in the serum but is due to the presence of a prothrombin-like derivative. 17 The same is true for the recalcified thrombocytopenic serum from normal plasma. The two-stage prothrombin determination of Ware and Seegers26 reveals less than 40 units per ml.…”

Section: Methodsmentioning

confidence: 84%

Function and Ultrastructure of Transfused, Surviving, Human Platelets in Patients with Thrombocytopenic Complicating Disease

et al. 1963

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Platelet concentrates prepared from freshly drawn blood were infused into patients with thrombocytopenic complicating disease. All exhibited a prolonged bleeding time, no clot retraction of a whole blood clot, platelet counts between 20,000 to 100,000 per cu. mm., usually, abnormal platelet ultrastructure and prothrombin consumption times under 15 seconds. Detection of platelet antibodies was attempted and the ultrastructure with a differential platelet count under the electron microscope of the patient's own platelets was documented. The platelet concentrates were given and it was possible to follow the fate of the donor's platelets by ultrastructural changes. Parallel studies of the coagulation mechanisms of the patients were followed serially. We found that some platelets survived up to seven days, although in some patients, platelets circulated but did not survive. Therefore immediate circulation of platelets cannot be equated with survival. In one patient with hypersplenism and a positive platelet agglutinin test no transfused platelets appeared to circulate. The ultrastructure of transfused platelets is greatly altered in bleeding patients. In the two patients with aplastic anemia and one with leukemia surviving platelets circulated which did not enter into the mechanisms of prothrombin activation, but which continued to circulate for some days with no improvement in the prothrombin consumption time over the pretransfusion level. Ultra‐structural studies of these platelets showed that the circulating platelets possessed their granules which contain platelet factor 3 activity. The differential platelet count under the electron miscroscope becomes abnormal as the donor platelets are stored. Our work suggests that the ultrastructure and differential platelet count of a platelet concentrate must be essentially normal for survival to be achieved. We confirmed the work of others indicating that donor platelets do not survive if stored or, if the recipient has detectable platelet antibodies. Donor platelets did not survive in some patients for reasons we could not explain. This may be dependent on utilization of platelets in hemostatic plugs, in thrombin production or for the endothelial supporting function but to date we cannot estimate to what extent or in what fashion a thrombocytopenic patient utilizes donor platelets.

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Section: Methodsmentioning

confidence: 84%

Function and Ultrastructure of Transfused, Surviving, Human Platelets in Patients with Thrombocytopenic Complicating Disease

et al. 1963

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“…I n this study, prothrombin was measured by a modified one-stage prothrombin time. In 1957, J o h n s o n and her associates (6) confirmed the finding that the serum prothrombin time of blood from patients with t h r o m b~c~t o p e n i a was short, (7) but observed that when the ~r o t h r o m b i n in the serum was measured by the two-stage method, it was as low as in the serum from normal blood. The implication arising from these findings that one-stage ~r o t h r o m b i n consumption test may not be a reliable determination of prothrombin prompted a restudy of prothrombin utilization comparing the one-stage with the two-stage method.…”

mentioning

confidence: 91%

The Prothrombin Consumption Time Test in Thrombocytopenia

Quick¹,

Geppret²

1963

Thromb Haemost

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SummaryThe serum from adult platelet-poor plasma has a residual prothrombin content nearly as high as that of the plasma when measured by either the prothrombin consumption test or the two-stage method of Ware and Seegers. Good agreement between the two methods is obtained when the prothrombin concentration is altered by such means as absorption with Ca3(PO4)2. The prothrombin consumption test is a simple but delicate measure of the function of platelets in the generation of intrinsic thromboplastin.

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Clinical Disorders Related to Blood Platelets

Bowie¹,

Owen²

1971

The Circulating Platelet

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The blood coagulation mechanisms in thrombocytopenic blood

Cited by 4 publications

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Function and Ultrastructure of Transfused, Surviving, Human Platelets in Patients with Thrombocytopenic Complicating Disease

Function and Ultrastructure of Transfused, Surviving, Human Platelets in Patients with Thrombocytopenic Complicating Disease

The Prothrombin Consumption Time Test in Thrombocytopenia

Clinical Disorders Related to Blood Platelets

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