PB0660 - Hemostasis system in children before and after splenectomy

Monday, June 24, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Presenting Author(s)

Elena A. Seregina, PhD

Leading Researcher
Dmitry Rogachev National Medical Research Centеr of Pediatric Hematology, Oncology and Immunology
Moscow, Moskva, Russia

Co-Author(s)

Alexander Poletaev

Head of the Laboratory of Clinical Hemostasis
Dmitry Rogachev National Medical Research Centеr of Pediatric Hematology, Oncology and Immunology
Moscow, Moskva, Russia
GS

Galina S. Svidelskaya

Junior researcher
Center for Theoretical Problems of Physicochemical Pharmacology RAS
Moscow, Moskva, Russia
EB

Elizaveta A. Bovt

research associate
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology
Moscow, Moskva, Russia
AI

Anastasia Ignatova

Research associate
Dmitry Rogachev National Medical Research Centеr of Pediatric Hematology, Oncology and Immunology
Moscow, Moskva, Russia
YC

Yaroslav M. Chuiko

Student of Pediatric Department
Pirogov Russian National Research Medical University
Moscow, Moskva, Russia
TV

Tatiana A. Vuimo

Leading researcher, P.h.D.
Center for Theoretical Problems of Physicochemical Pharmacology
Moscow, Moskva, Russia
FA

Fazoil I. Ataullakhanov

Dr.Sci.Biol., Head of Biophysics and Systems Biology Department
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology
Moscow, Moskva, Russia
NS

Nataliya S. Smetanina

Dr.Sci.Med.,Director of the Department for Scientific and Analytical Work with Regions, Hematologist
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology
Moscow, Moskva, Russia

Background: The laboratory diagnostics of the hemostasis state in patients before and after splenectomy remains a relevant question.

Aims: The aim was to evaluate platelet and plasma coagulation before and after splenectomy.

Methods: The hemostasis of 12 children(5 boys and 7 girls, age: 8-17 yrs) with hereditary spherocytosis(HS) and 2 boys (9 and 13 yrs) with autoimmune hemolytic anemia (AIHA) was described using clotting times(APTT, PT), fibrinogen, ATIII, proteins C and S, von Willebrand Factor(vWF:Ag) and D-dimer levels, platelet aggregometry with ADP, collagen, adrenaline, thrombin, and global hemostasis assay (thrombodynamics (TD), thromboelastography (TEG) in two points before and 3-5 days after splenectomy.

Results: Hematomas in the bed of the removed spleen were visualized in 2 patients with HS and 1 patient with AIHA on a control abdominal ultrasound. Patients were divided into 2 groups: with (1st) and without(2nd) hemorrhage. Clotting times and aggregometry were almost normal in all patients before and after splenectomy despite the increase of PLT levels in most patients (257±127 vs 432±221*109/l). We reveal the statistically significant (p < 0.01) increase in fibrinogen (2,01±0,69 vs 4,11±1,74g/l) and D-dimer (90±46 vs 1240±2331ng/ml) after splenectomy in all patients. We do not reveal the statistically significant changes in PC, ATIII levels but 4 patients without hemorrhage reveal the decrease of PS levels. Patients without hemorrhage reveal the statistically significant increase of vWF:Ag(161±39 vs 168±56%in 1st group, 113±50 vs 166±88% in 2nd group), TEG alpha angle(42±17 vs 51±9deg in 1st group, 40±16 vs 57+8deg in 2nd group) and TD clot growth(64±4 vs 57±2μm/min in 1st group, 56±7 vs 57±9μm/min in 2nd group) after compare to before levels despite the group with complications, even the TD clot growth were lower than before surgery.

Conclusion(s): Postoperative hypercoagulation(revealed by vWF, TEG, TD,PS) is normal for wound healing. The patients whose global assays parameters were lower after surgery had hemorrhagic complication.