<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN"
"http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html>
<head>
<title>UTas ePrints - Emerging technologies in hemostasis diagnostics: A report from the Australasian Society of Thrombosis and Haemostasis Emerging Technologies Group</title>
<script type="text/javascript" src="http://eprints.utas.edu.au/javascript/auto.js"><!-- padder --></script>
<style type="text/css" media="screen">@import url(http://eprints.utas.edu.au/style/auto.css);</style>
<style type="text/css" media="print">@import url(http://eprints.utas.edu.au/style/print.css);</style>
<link rel="icon" href="/images/eprints/favicon.ico" type="image/x-icon" />
<link rel="shortcut icon" href="/images/eprints/favicon.ico" type="image/x-icon" />
<link rel="Top" href="http://eprints.utas.edu.au/" />
<link rel="Search" href="http://eprints.utas.edu.au/cgi/search" />
<meta content="Adams, M.J." name="eprints.creators_name" />
<meta content="Ward, C." name="eprints.creators_name" />
<meta content="Thom, J." name="eprints.creators_name" />
<meta content="Bianchi, A." name="eprints.creators_name" />
<meta content="Perrin, E." name="eprints.creators_name" />
<meta content="Coghlan, D." name="eprints.creators_name" />
<meta content="Smith, M." name="eprints.creators_name" />
<meta content="Murray.Adams@utas.edu.au" name="eprints.creators_id" />
<meta content="" name="eprints.creators_id" />
<meta content="" name="eprints.creators_id" />
<meta content="" name="eprints.creators_id" />
<meta content="" name="eprints.creators_id" />
<meta content="" name="eprints.creators_id" />
<meta content="" name="eprints.creators_id" />
<meta content="article" name="eprints.type" />
<meta content="2007-09-12" name="eprints.datestamp" />
<meta content="2008-01-08 15:30:00" name="eprints.lastmod" />
<meta content="show" name="eprints.metadata_visibility" />
<meta content="Emerging technologies in hemostasis
diagnostics: A report from the Australasian
Society of Thrombosis and Haemostasis
Emerging Technologies Group" name="eprints.title" />
<meta content="pub" name="eprints.ispublished" />
<meta content="321008" name="eprints.subjects" />
<meta content="restricted" name="eprints.full_text_status" />
<meta content="Hemostasis, laboratory testing, thrombin generation, thrombophilia, bleeding" name="eprints.keywords" />
<meta content="Copyright 2007, Georg Thieme Verlag. Definitive version is available online at http://www.thieme-connect.de/ejournals/toc/sth/6268" name="eprints.note" />
<meta content="Technology in hemostasis laboratories has evolved enormously during the last
30 years. Although many scientists and clinicians will remember the traditional tilt-tube
techniques to screen for coagulation abnormalities and to monitor anticoagulant therapy,
the hemostasis laboratory today uses a variety of modern technologies. These include flow
cytometry, chromogenic assays, molecular typing (e.g., polymerase chain reaction), immunologic
assays (e.g., enzyme-linked immunosorbent assays), functional assays of specific
coagulation proteins, and platelet function analyzers. Although these advances in technology
have resulted in greater capability, productivity, sensitivity, specificity, and ultimately,
improvement in the clinical care of patients, controversies and limitations remain.
This article highlights new and emerging technologies in hemostasis and discusses whether
they have improved or are likely to improve laboratory diagnostics by specifically addressing
the following: (1) Can new technologies help predict likelihood of thrombosis recurrence?
(2) Has an understanding of the role of a disintegrin-like and metalloprotease with
thrombospondin type 1 motifs (ADAMTS13) in microangiopathy resulted in improved
diagnostic methods for this disorder? (3) Does thrombelastography allow better definition
of bleeding risk than conventional hemostasis assays, especially in settings of acute
hemostatic pathology?" name="eprints.abstract" />
<meta content="2007-04" name="eprints.date" />
<meta content="published" name="eprints.date_type" />
<meta content="Seminars in Thrombosis and Hemostasis" name="eprints.publication" />
<meta content="33" name="eprints.volume" />
<meta content="3" name="eprints.number" />
<meta content="226-234" name="eprints.pagerange" />
<meta content="10.1055/s-2007-971808" name="eprints.id_number" />
<meta content="UNSPECIFIED" name="eprints.thesis_type" />
<meta content="TRUE" name="eprints.refereed" />
<meta content="0094-6176" name="eprints.issn" />
<meta content="http://dx.doi.org/10.1055/s-2007-971808" name="eprints.official_url" />
<meta content="1. Prandoni P, Lensing AW, Cogo A, et al. The long-term
clinical course of acute deep venous thrombosis. Ann Intern
Med 1996;125:1–7
2. Schulman S, Svenungsson E, Granqvist S. Anticardiolipin
antibodies predict early recurrence of thromboembolism and
death among patients with venous thromboembolism following
anticoagulant therapy. Duration of Anticoagulation
Study Group. Am J Med 1998;104:332–338
3. Kearon C, Gent M, Hirsh J, et al. A comparison of three
months of anticoagulation with extended anticoagulation for
a first episode of idiopathic venous thromboembolism.
N Engl J Med 1999;340:901–907
4. Kraaijenhagen RA, Haverkamp D, Koopman MM, et al.
High plasma concentration of factor VIIIc is a major risk
factor for venous thromboembolism. Thromb Haemost 2000;
83:5–9
5. Kyrle PA, Minar E, Hisrchl M, et al. High plasma levels of
factor VIII and the risk of recurrent venous thromboembolism.
N Engl J Med 2000;343:457–462
EMERGING TECHNOLOGIES IN HEMOSTASIS DIAGNOSTICS/ADAMS ET AL 2316. Kyrle PA, Eichinger S. The risk of recurrent venous
thromboembolism: the Austrian Study on Recurrent Venous
Thromboembolism (review). Wien Klin Wochenschr 2003;
115:471–474
7. Santamaria MG, Agnelli G, Taliani MR, et al. Thrombophilic
abnormalities and recurrence of venous thromboembolism
in patients treated with standardized anticoagulant
treatment. Thromb Res 2005;116:301–306
8. Vossen CY, Walker ID, Svensson P, et al. Recurrence rate
after a first venous thrombosis in patients with familial
thrombophilia. Arterioscler Thromb Vasc Biol 2005;25:
1992–1997
9. Ke´vorkian J-P, Halimi C, Segrestaa J-M, et al. Monitoring
of patients with deep-vein thrombosis during and after
anticoagulation with D-dimer. Lancet 1998;351:571–
572
10. Fattorini A, Crippa L, D’Angelo SV, et al. Risk of deep vein
thrombosis recurrence: high negative predictive value of
D-dimer performed during oral anticoagulation. Thromb
Haemost 2002;88:162–163
11. Palareti G, Legnani C, Cosmi B, et al. Risk of venous
thromboembolism recurrence: high negative predictive value
of D-dimer performed after oral anticoagulation is stopped.
Thromb Haemost 2002;87:7–12
12. Palareti G, Legnani C, Cosmi B, et al. Predictive value of
D-dimer test for recurrent venous thromboembolism after
anticoagulation withdrawal in subjects with a previous
idiopathic event and in carriers of congenital thrombophilia.
Circulation 2003;108:313–318
13. Cosmi B, Legnani C, Cini M, et al. D-dimer levels in
combination with residual venous obstruction and the risk of
recurrence after anticoagulation withdrawal for a first
idiopathic deep vein thrombosis. Thromb Haemost 2005;
94:969–974
14. Baglin T. The measurement and application of thrombin
generation. Br J Haematol 2005;130:653–661
15. Wielders S, Mukherjee M, Michiels J, et al. The routine
determination of the endogenous thrombin potential, first
results in different forms of hyper- and hypocoagulability.
Thromb Haemost 1997;77:629–636
16. Hemker HC, Giesen P, Al Dieri R, et al. The calibrated
automated thrombogram (CAT): a universal routine test for
hyper- and hypocoagulability. Pathophysiol Haemost Thromb
2002;32:249–253
17. Hemker HC, Giesen PLA, Al Dieri R, et al. Calibrated
automated thrombin generation measurement in clotting
plasma. Pathophysiol Haemost Thromb 2003;33:4–15
18. Gerotziafas GT, Despasse F, Busson J, et al. Towards a
standardization of thrombin generation assessment: the
influence of tissue factor, platelets and phospholipids
concentration on the normal values of Thrombogram-
Thrombinoscope assay. Thromb J 2005;3:16
19. Andresen MS, Abilgaard U, Liestol S, et al. The ability of
three global plasma assays to recognize thrombophilia.
Thromb Res 2004;113:411–417
20. Regnault V, Hemker HC, Wahlo D, et al. Phenotyping the
haemostatic system by thrombography—potential for the
estimation of thrombotic risk. Thromb Res 2004;114:539–
545
21. Eichinger S, Weltermann A, Phillip K, et al. Prospective
evaluation of haemostatic system activation and thrombin
potential in healthy pregnant women with and without factor
V Leiden. Thromb Haemost 1999;82:1232–1236
22. Hron G, Kollars M, Binder BR, et al. Identification of
patients at low risk for recurrent venous thromboembolism
by measuring thrombin generation. JAMA 2006;296:397–
402
23. He S, Antovic A, Blo¨mback M. A simple and rapid
laboratory method for determination of haemostasis potential
in plasma—II. Modifications for use in routine laboratories
and research work. Thromb Res 2001;103:355–361
24. Antovic A, Blomba¨ck M, Bremme K, et al. Increased
hemostasis potential persists in women with previous
thromboembolism with or without APC resistance.
J Thromb Haemost 2003;1:2531–2535
25. Morel-Kopp M-C, Curnow J, Aboud M, et al. Discrepancies
between the overall coagulation potential (OCP) assay and
international normalised ratio (INR) in warfarin-treated
patients. J Thromb Haemost 2005;3(suppl 1):1376
26. Exner T, Joseph J, Low J, et al. A new activated factor Xbased
clotting method with improved specificity for procoagulant
phospholipids. Blood Coagul Fibrinolysis 2003;14:
773–779
27. Favaloro EJ, Soltani S, McDonald J, et al. Laboratory
identification of familial thrombophilia: do the pitfalls
exceed the benefits? A reassessment of ABO-blood group,
gender, age, and other laboratory parameters on the
potential influence on a diagnosis of protein c, protein s,
and antithrombin deficiency and the potential high risk of
a false positive diagnosis. Lab Hematol 2005;11:174–
184
28. Byrnes JJ, Khurana M. Treatment of thrombotic thrombocytopenic
purpura with plasma. N Engl J Med 1977;297:
1386–1389
29. George JN. How I treat patients with thrombotic thrombocytopenic
purpura-hemolytic uremic syndrome. Blood 2000;
96:1223–1229
30. Furlan M, Robles R, La¨mmle B. Partial purification and
characterization of a protease from human plasma cleaving
von Willebrand factor to fragments produced by in vivo
proteolysis. Blood 1996;87:4223–4234
31. Tsai HM. Physiological cleavage of von Willebrand factor by
a plasma protease is dependent on its conformation and
requires calcium ion. Blood 1996;87:4235–4244
32. Furlan M, Robles R, Solenthaler M, et al. Deficient activity
of von Willebrand factor cleavage-cleaving protease in a
patient with thrombotic thrombocytopenic purpura. Blood
1997;89:3097–3103
33. Furlan M, Robles R, Solenthaler M, et al. Acquired
deficiency of von Willebrand factor cleavage-cleaving protease
in a patient with thrombotic thrombocytopenic purpura.
Blood 1998;91:2839–2846
34. Zheng X, Chung D, Tkayama TK, et al. Structure of von
Willebrand factor-cleaving protease (ADAMTS13), a metalloprotease
involved in thrombotic thrombocytopenic purpura.
J Biol Chem 2001;276:41059–41063
35. Moake JL, Rudy CK, Troll JH, et al. Unusually large plasma
FVIII:von Willebrand factor multimers in chronic relapsing
thrombotic thrombocytopenic purpura. N Engl J Med 1982;
307:1432–1435
36. La¨mmle B, Kremer Hovinga JA, Alberio L. Thrombotic
thrombocytopenic purpura. J Thromb Haemost 2005;3:
1663–1675
37. Moake JL. Von Willebrand factor, ADAMTS-13 and
thrombotic thrombocytopenic purpura. Semin Hematol
2004;41:4–14
232 SEMINARS IN THROMBOSIS AND HEMOSTASIS/VOLUME 33, NUMBER 3 2007
38. Meyer D, Obert B, Pietu G, et al. Multimeric structure of
factor VIII/von Willebrand factor in von Willebrand’s
disease. J Lab Clin Med 1980;95:590–602
39. Baillod P, Affolter B, Kurt GH, et al. Multimeric analysis of
von Willebrand factor by vertical sodium dodecyl sulphate
agarose gel electrophoresis, vacuum blotting technology and
sensitive visualisation by alkaline phosphatase complex.
Thromb Res 1992;66:745–755
40. Veyradier A, Girma J-P. Assays of ADAMTS-13 activity.
Semin Hematol 2004;41:41–47
41. Allford SL, Harrison P, Lawrie AS, et al. von Willebrand
factor-cleaving protease activity in congenital thrombotic
thrombocytopenic purpura. Br J Haematol 2000;111:1215–
1222
42. Van der Plas RM, Schiphorst ME, Huizinga EG, et al. von
Willebrand factor proteolysis is deficient in classic, but not in
bone marrow transplantation-associated, thrombotic thrombocytopenic
purpura. Blood 1999;93:3798–3802
43. Krizek DM, Rick ME. A rapid method to visualize von
Willebrand factor multimers by using agarose electrophoresis,
immunolocalization and luminographic detection. Thromb
Res 2000;97:457–462
44. Obert B, Tout H, Veyradier A, et al. Estimation of the von
Willebrand factor-cleaving protease in plasma using monoclonal
antibodies to vWF. Thromb Haemost 1999;82:1382–
1385
45. Veyradier A, Obert B, Houllier A, et al. Specific von
Willebrand factor-cleaving protease in thrombotic microangiopathies.
Blood 2001;98:1765–1772
46. Gerritsen HE, Turecek PL, Schwartz HP, et al. Assay of von
Willebrand factor (vWF)-cleaving protease based on
decreased collagen binding affinity of degraded vWF: a tool
for the diagnosis of thrombotic thrombocytopenic purpura
(TTP). Thromb Haemost 1999;82:1386–1389
47. Aronson DL, Krizek DM, Rick ME. A rapid assay for the
vWF protease. Thromb Haemost 2001;85:184–185
48. Schneppenheim R, Budde U, Oyen F, et al. von Willebrand
cleaving protease and ADAMTS-13 mutations in childhood
TTP. Blood 2003;101:1845–1850
49. Bo¨hm M, Vigh T, Scharrer I. Evaluation and clinical
application of a new method for measuring activity of von
Willebrand factor-cleaving metalloprotease (ADAMTS-13).
Ann Hematol 2002;81:430–435
50. Kostousov V, Fehr J, Bombeli T. Novel, semi-automated, 60-
min-assay to determine von Willebrand factor cleaving
activity of ADAMTS-13. Thromb Res 2006;118:723–731
51. Shenkman B, Budde U, Angerhaus D, et al. D. ADAMTS-
13 regulates platelet adhesion under flow. Thromb Haemost
2006;96:160–166
52. Kokame K, Nobe Y, Kokubo Y, et al. FRETS-VWF73, a
first fluorogenic substrate for ADAMTS-13 assay. Br J
Haematol 2005;129:93–100
53. Yagi H, Matsumoto M, Iwamoto T, et al. Heightened
proteolysis of plasma ADAMTS-13 antigen in patients with
thrombotic thrombocytopenic purpura. Blood 2004;104:
3946(Abst)
54. Wu J-J, Fujikawa K, Lian EC, et al. A rapid enzyme linked
assay for ADAMTS-13. J Thromb Haemost 2006;4:129–136
55. Rieger M, Ferrari S, Kremer Hovinga JA, et al. Relation
between ADAMTS-13 activity and ADAMTS-13 antigen
levels in healthy donors and patients with thrombotic
microangiopathies (TMA). Thromb Haemost 2006;95:212–
220
56. Feys HB, Liu F, Dong N, et al. ADAMTS-13 plasma level
determination uncovers antigen absence in acquired thrombotic
thrombocytopenic purpura and ethnic differences.
J Thromb Haemost 2006;4:955–962
57. Park YD, Yoshioka A, Kawa K, et al. Impaired activity of von
Willebrand factor-cleaving protease may predict the occurrence
of hepatic veno-occlusive disease after stem cell
transplantation. Bone Marrow Transplant 2002;29:789–794
58. Scheiflinger F, Kno¨bl P, Trattner B, et al. Nonneutralizing
IgM and IgG antibodies to von Willebrand factor cleaving
protease in a patient with thrombotic thrombocytopenic
purpura. Blood 2003;102:3241–3243
59. Kremer Hovinga JA, Studt JD, Alberio L, et al. von
Willebrand factor-cleaving protease (ADAMTS13) activity
determination in the diagnosis of thrombotic microangiopathies:
the Swiss experience. Semin Hematol 2004;41:75–
82
60. Remuzzi G. Is ADAMTS-13 deficiency specific for thrombotic
thrombocytopenic purpura? J Thromb Haemost 2003;
1:632–634
61. Tsai HM. Is severe deficiency of ADAMTS-13 specific for
thrombotic thrombocytopenic purpura? Yes. J Thromb
Haemost 2003;1:625–631
62. Loof AH, van Vliet HH, Kappers-Klunne MC. Low activity
of von Willebrand factor-cleaving protease is not restricted to
patients suffering from thrombotic thrombocytopenic purpura.
Br J Haematol 2001;112:1087–1088
63. Moore JC, Hayward CP, Warkentin TE, et al. Decreased
von Willebrand factor protease activity associated with
thrombocytopenic disorders. Blood 2001;98:1842–1846
64. Koh MB, Hunt BJ. The management of peri-operative
bleeding. Blood Rev 2003;17:179–185
65. Levy JH. Massive transfusion coagulopathy. Semin Hematol
2006;43(1, suppl 1):S59–S63
66. Rivard GE, Brummel-Ziedins KE, Mann KG, et al.
Evaluation of the profile of thrombin generation during the
process of whole blood clotting as assessed by thromboelastography.
J Thromb Haemost 2005;3:2039–2043
67. Kolde HJ, Strobel GA. Whole blood global haemostasis assay
via collagen mediated activation of the haemostasis system.
Ann Hematol 2003;82(suppl 1):S147
68. Mallett SV, Cox DJA. Thromboelastography. Br J Anaesth
1992;69:307–313
69. Avidan MS, Alcock EL, Da Fonseca J, et al. Comparison of
structured use of routine laboratory tests or near patient
assessment with clinical judgment in the management of
bleeding after cardiac surgery. Br J Anaesth 2004;92:178–186
70. Luddington RJ. Thrombelastography/thromboelastometry.
Clin Lab Haematol 2005;27:81–90
71. Piraccini E, Zanzani C, Caporossi E. Intraoperative
coagulation monitoring and small bowel transplantation: a
way to explore. Transplant Proc 2006;38:823–825
72. Gillies BS. Thromboelastography and liver transplantation.
Semin Thromb Hemost 1995;21(suppl 4):45–49
73. Kaufmann CR, Dwyer KM, Crews JD, et al. Usefulness of
thromboelastography in assessment of trauma patient coagulation.
J Trauma 1997;42:716–720
74. Vorweg M, Hipp RFJ, Schindler A, et al. Management of
coagulation in trauma patients using a new monitoring
method. Anesth Analg 1996;82:S54
75. Fries D, Innerhofer P, Schobersberger W. Coagulation
management in trauma patients. Curr Opin Anaesthesiol
2002;15:217–223
EMERGING TECHNOLOGIES IN HEMOSTASIS DIAGNOSTICS/ADAMS ET AL 233
76. Savry C, Quinio P, Lefevre F, et al. Manageability and
potential for haemostasis monitoring by near-patient modi-
fied thromboelastometer (Rotem) in intensive care unit. Ann
Fr Anesth Reanim 2005;24:607–616
77. Pusateri AE, Park MS. Mechanist implications for the use
and monitoring of recombinant activated factor VII in
trauma. Crit Care 2005;9(Suppl 5):S15–S24
78. Ingerslev J, Christiansen K, Calatzis A, et al. Management
and monitoring of recombinant factor VII. Blood Coagul
Fibrinolysis 2000;11(suppl 1):S25–S30
79. Kawaguchi C, Takahashi Y, Hanesaka Y, et al. The in vitro
analysis of the coagulation mechanism of activated factor VII
using thromboelastogram.ThrombHaemost 2002;88:768–772
80. Shore-Lesserson L, Manspeizer H, DePerio M, et al.
Thromboelastography-guided transfusion algorithm reduces
transfusion in complex cardiac surgery. Anesth Analg 1999;
88:312–319
81. Royston D, von Kier S. Reduced haemostatic factor
transfusion using heparinase-modified thromboelastography
during cardio-pulmonary by-pass. Br J Anaesth 2001;86:
575–578
82. Anderson L, Quasim I, Steven M, et al. An audit of red cell
and blood product use after institution of thromboelastography
in a cardiac intensive care unit. Br J Haematol 2003;
121(suppl 1):80
83. Williams GD, Bratton SL, Riley EC, et al. Coagulation tests
during cardiopulmonary bypass correlate with blood loss in
children undergoing cardiac surgery. J Cardiothorac Vasc
Anesth 1999;13:398–404
84. Cammerer U, Dietrich W, Rampf T, et al. The predictive
value of modified computerized thromboelastography
and platelet function analysis for postoperative blood loss
in routine cardiac surgery. Anesth Analg 2003;96:51–
57
85. Wettstein P, Haeberli A, Stutz M, et al. Decreased factor
XIII availability for thrombin and early loss of clot firmness
in patients with unexplained intraoperative bleeding. Anesth
Analg 2004;99:1564–1569
234 SEMINARS IN THROMBOSIS AND HEMOSTASIS/VOLUME 33, NUMBER 3 2007" name="eprints.referencetext" />
<meta content="Adams, M.J. and Ward, C. and Thom, J. and Bianchi, A. and Perrin, E. and Coghlan, D. and Smith, M. (2007) Emerging technologies in hemostasis diagnostics: A report from the Australasian Society of Thrombosis and Haemostasis Emerging Technologies Group. Seminars in Thrombosis and Hemostasis, 33 (3). pp. 226-234. ISSN 0094-6176" name="eprints.citation" />
<meta content="http://eprints.utas.edu.au/1773/1/Adams_etal_2007_(ASTH).pdf" name="eprints.document_url" />
<link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" />
<meta content="Emerging technologies in hemostasis
diagnostics: A report from the Australasian
Society of Thrombosis and Haemostasis
Emerging Technologies Group" name="DC.title" />
<meta content="Adams, M.J." name="DC.creator" />
<meta content="Ward, C." name="DC.creator" />
<meta content="Thom, J." name="DC.creator" />
<meta content="Bianchi, A." name="DC.creator" />
<meta content="Perrin, E." name="DC.creator" />
<meta content="Coghlan, D." name="DC.creator" />
<meta content="Smith, M." name="DC.creator" />
<meta content="321008 Haematology" name="DC.subject" />
<meta content="Technology in hemostasis laboratories has evolved enormously during the last
30 years. Although many scientists and clinicians will remember the traditional tilt-tube
techniques to screen for coagulation abnormalities and to monitor anticoagulant therapy,
the hemostasis laboratory today uses a variety of modern technologies. These include flow
cytometry, chromogenic assays, molecular typing (e.g., polymerase chain reaction), immunologic
assays (e.g., enzyme-linked immunosorbent assays), functional assays of specific
coagulation proteins, and platelet function analyzers. Although these advances in technology
have resulted in greater capability, productivity, sensitivity, specificity, and ultimately,
improvement in the clinical care of patients, controversies and limitations remain.
This article highlights new and emerging technologies in hemostasis and discusses whether
they have improved or are likely to improve laboratory diagnostics by specifically addressing
the following: (1) Can new technologies help predict likelihood of thrombosis recurrence?
(2) Has an understanding of the role of a disintegrin-like and metalloprotease with
thrombospondin type 1 motifs (ADAMTS13) in microangiopathy resulted in improved
diagnostic methods for this disorder? (3) Does thrombelastography allow better definition
of bleeding risk than conventional hemostasis assays, especially in settings of acute
hemostatic pathology?" name="DC.description" />
<meta content="2007-04" name="DC.date" />
<meta content="Article" name="DC.type" />
<meta content="PeerReviewed" name="DC.type" />
<meta content="application/pdf" name="DC.format" />
<meta content="http://eprints.utas.edu.au/1773/1/Adams_etal_2007_(ASTH).pdf" name="DC.identifier" />
<meta content="http://dx.doi.org/10.1055/s-2007-971808" name="DC.relation" />
<meta content="Adams, M.J. and Ward, C. and Thom, J. and Bianchi, A. and Perrin, E. and Coghlan, D. and Smith, M. (2007) Emerging technologies in hemostasis diagnostics: A report from the Australasian Society of Thrombosis and Haemostasis Emerging Technologies Group. Seminars in Thrombosis and Hemostasis, 33 (3). pp. 226-234. ISSN 0094-6176" name="DC.identifier" />
<meta content="http://eprints.utas.edu.au/1773/" name="DC.relation" />
<link rel="alternate" href="http://eprints.utas.edu.au/cgi/export/1773/BibTeX/epprod-eprint-1773.bib" title="BibTeX" type="text/plain" />
<link rel="alternate" href="http://eprints.utas.edu.au/cgi/export/1773/ContextObject/epprod-eprint-1773.xml" title="OpenURL ContextObject" type="text/xml" />
<link rel="alternate" href="http://eprints.utas.edu.au/cgi/export/1773/ContextObject::Dissertation/epprod-eprint-1773.xml" title="OpenURL Dissertation" type="text/xml" />
<link rel="alternate" href="http://eprints.utas.edu.au/cgi/export/1773/ContextObject::Journal/epprod-eprint-1773.xml" title="OpenURL Journal" type="text/xml" />
<link rel="alternate" href="http://eprints.utas.edu.au/cgi/export/1773/DC/epprod-eprint-1773.txt" title="Dublin Core" type="text/plain" />
<link rel="alternate" href="http://eprints.utas.edu.au/cgi/export/1773/DIDL/epprod-eprint-1773.xml" title="DIDL" type="text/xml" />
<link rel="alternate" href="http://eprints.utas.edu.au/cgi/export/1773/EndNote/epprod-eprint-1773.enw" title="EndNote" type="text/plain" />
<link rel="alternate" href="http://eprints.utas.edu.au/cgi/export/1773/HTML/epprod-eprint-1773.html" title="HTML Citation" type="text/html; charset=utf-8" />
<link rel="alternate" href="http://eprints.utas.edu.au/cgi/export/1773/METS/epprod-eprint-1773.xml" title="METS" type="text/xml" />
<link rel="alternate" href="http://eprints.utas.edu.au/cgi/export/1773/MODS/epprod-eprint-1773.xml" title="MODS" type="text/xml" />
<link rel="alternate" href="http://eprints.utas.edu.au/cgi/export/1773/RIS/epprod-eprint-1773.ris" title="Reference Manager" type="text/plain" />
<link rel="alternate" href="http://eprints.utas.edu.au/cgi/export/1773/Refer/epprod-eprint-1773.refer" title="Refer" type="text/plain" />
<link rel="alternate" href="http://eprints.utas.edu.au/cgi/export/1773/Simple/epprod-eprint-1773text" title="Simple Metadata" type="text/plain" />
<link rel="alternate" href="http://eprints.utas.edu.au/cgi/export/1773/Text/epprod-eprint-1773.txt" title="ASCII Citation" type="text/plain; charset=utf-8" />
<link rel="alternate" href="http://eprints.utas.edu.au/cgi/export/1773/XML/epprod-eprint-1773.xml" title="EP3 XML" type="text/xml" />
</head>
<body bgcolor="#ffffff" text="#000000" onLoad="loadRoutine(); MM_preloadImages('images/eprints/ePrints_banner_r5_c5_f2.gif','images/eprints/ePrints_banner_r5_c7_f2.gif','images/eprints/ePrints_banner_r5_c8_f2.gif','images/eprints/ePrints_banner_r5_c9_f2.gif','images/eprints/ePrints_banner_r5_c10_f2.gif','images/eprints/ePrints_banner_r5_c11_f2.gif','images/eprints/ePrints_banner_r6_c4_f2.gif')">
<div class="ep_noprint"><noscript><style type="text/css">@import url(http://eprints.utas.edu.au/style/nojs.css);</style></noscript></div>
<table width="795" border="0" cellspacing="0" cellpadding="0">
<tr>
<td><script language="JavaScript1.2">mmLoadMenus();</script>
<table border="0" cellpadding="0" cellspacing="0" width="795">
<!-- fwtable fwsrc="eprints_banner_final2.png" fwbase="ePrints_banner.gif" fwstyle="Dreamweaver" fwdocid = "1249563342" fwnested="0" -->
<tr>
<td><img src="/images/eprints/spacer.gif" width="32" height="1" border="0" alt="" /></td>
<td><img src="/images/eprints/spacer.gif" width="104" height="1" border="0" alt="" /></td>
<td><img src="/images/eprints/spacer.gif" width="44" height="1" border="0" alt="" /></td>
<td><img src="/images/eprints/spacer.gif" width="105" height="1" border="0" alt="" /></td>
<td><img src="/images/eprints/spacer.gif" width="41" height="1" border="0" alt="" /></td>
<td><img src="/images/eprints/spacer.gif" width="16" height="1" border="0" alt="" /></td>
<td><img src="/images/eprints/spacer.gif" width="68" height="1" border="0" alt="" /></td>
<td><img src="/images/eprints/spacer.gif" width="68" height="1" border="0" alt="" /></td>
<td><img src="/images/eprints/spacer.gif" width="68" height="1" border="0" alt="" /></td>
<td><img src="/images/eprints/spacer.gif" width="82" height="1" border="0" alt="" /></td>
<td><img src="/images/eprints/spacer.gif" width="69" height="1" border="0" alt="" /></td>
<td><img src="/images/eprints/spacer.gif" width="98" height="1" border="0" alt="" /></td>
<td><img src="/images/eprints/spacer.gif" width="1" height="1" border="0" alt="" /></td>
</tr>
<tr>
<td colspan="12"><img name="ePrints_banner_r1_c1" src="/images/eprints/ePrints_banner_r1_c1.gif" width="795" height="10" border="0" alt="" /></td>
<td><img src="/images/eprints/spacer.gif" width="1" height="10" border="0" alt="" /></td>
</tr>
<tr>
<td rowspan="6"><img name="ePrints_banner_r2_c1" src="/images/eprints/ePrints_banner_r2_c1.gif" width="32" height="118" border="0" alt="" /></td>
<td rowspan="5"><a href="http://www.utas.edu.au/"><img name="ePrints_banner_r2_c2" src="/images/eprints/ePrints_banner_r2_c2.gif" width="104" height="103" border="0" alt="" /></a></td>
<td colspan="10"><img name="ePrints_banner_r2_c3" src="/images/eprints/ePrints_banner_r2_c3.gif" width="659" height="41" border="0" alt="" /></td>
<td><img src="/images/eprints/spacer.gif" width="1" height="41" border="0" alt="" /></td>
</tr>
<tr>
<td colspan="3"><a href="http://eprints.utas.edu.au/"><img name="ePrints_banner_r3_c3" src="/images/eprints/ePrints_banner_r3_c3.gif" width="190" height="31" border="0" alt="" /></a></td>
<td rowspan="2" colspan="7"><img name="ePrints_banner_r3_c6" src="/images/eprints/ePrints_banner_r3_c6.gif" width="469" height="37" border="0" alt="" /></td>
<td><img src="/images/eprints/spacer.gif" width="1" height="31" border="0" alt="" /></td>
</tr>
<tr>
<td colspan="3"><img name="ePrints_banner_r4_c3" src="/images/eprints/ePrints_banner_r4_c3.gif" width="190" height="6" border="0" alt="" /></td>
<td><img src="/images/eprints/spacer.gif" width="1" height="6" border="0" alt="" /></td>
</tr>
<tr>
<td colspan="2"><img name="ePrints_banner_r5_c3" src="/images/eprints/ePrints_banner_r5_c3.gif" width="149" height="1" border="0" alt="" /></td>
<td rowspan="2" colspan="2"><a href="/information.html" onMouseOut="MM_swapImgRestore();MM_startTimeout()" onMouseOver="MM_showMenu(window.mm_menu_0821132634_0,0,25,null,'ePrints_banner_r5_c5');MM_swapImage('ePrints_banner_r5_c5','','/images/eprints/ePrints_banner_r5_c5_f2.gif',1);"><img name="ePrints_banner_r5_c5" src="/images/eprints/ePrints_banner_r5_c5.gif" width="57" height="25" border="0" alt="About" /></a></td>
<td rowspan="2"><a href="/view/" onMouseOut="MM_swapImgRestore();MM_startTimeout()" onMouseOver="MM_showMenu(window.mm_menu_0821133021_1,0,25,null,'ePrints_banner_r5_c7');MM_swapImage('ePrints_banner_r5_c7','','/images/eprints/ePrints_banner_r5_c7_f2.gif',1);"><img name="ePrints_banner_r5_c7" src="/images/eprints/ePrints_banner_r5_c7.gif" width="68" height="25" border="0" alt="Browse" /></a></td>
<td rowspan="2"><a href="/perl/search/simple" onMouseOut="MM_swapImgRestore();MM_startTimeout()" onMouseOver="MM_showMenu(window.mm_menu_0821133201_2,0,25,null,'ePrints_banner_r5_c8');MM_swapImage('ePrints_banner_r5_c8','','/images/eprints/ePrints_banner_r5_c8_f2.gif',1);"><img name="ePrints_banner_r5_c8" src="/images/eprints/ePrints_banner_r5_c8.gif" width="68" height="25" border="0" alt="Search" /></a></td>
<td rowspan="2"><a href="/perl/register" onMouseOut="MM_swapImgRestore();MM_startTimeout();" onMouseOver="MM_showMenu(window.mm_menu_1018171924_3,0,25,null,'ePrints_banner_r5_c9');MM_swapImage('ePrints_banner_r5_c9','','/images/eprints/ePrints_banner_r5_c9_f2.gif',1);"><img name="ePrints_banner_r5_c9" src="/images/eprints/ePrints_banner_r5_c9.gif" width="68" height="25" border="0" alt="register" /></a></td>
<td rowspan="2"><a href="/perl/users/home" onMouseOut="MM_swapImgRestore();MM_startTimeout()" onMouseOver="MM_showMenu(window.mm_menu_0821133422_4,0,25,null,'ePrints_banner_r5_c10');MM_swapImage('ePrints_banner_r5_c10','','/images/eprints/ePrints_banner_r5_c10_f2.gif',1);"><img name="ePrints_banner_r5_c10" src="/images/eprints/ePrints_banner_r5_c10.gif" width="82" height="25" border="0" alt="user area" /></a></td>
<td rowspan="2"><a href="/help/" onMouseOut="MM_swapImgRestore();MM_startTimeout()" onMouseOver="MM_showMenu(window.mm_menu_0821133514_5,0,25,null,'ePrints_banner_r5_c11');MM_swapImage('ePrints_banner_r5_c11','','/images/eprints/ePrints_banner_r5_c11_f2.gif',1);"><img name="ePrints_banner_r5_c11" src="/images/eprints/ePrints_banner_r5_c11.gif" width="69" height="25" border="0" alt="Help" /></a></td>
<td rowspan="3" colspan="4"><img name="ePrints_banner_r5_c12" src="/images/eprints/ePrints_banner_r5_c12.gif" width="98" height="40" border="0" alt="" /></td>
<td><img src="/images/eprints/spacer.gif" width="1" height="1" border="0" alt="" /></td>
</tr>
<tr>
<td rowspan="2"><img name="ePrints_banner_r6_c3" src="/images/eprints/ePrints_banner_r6_c3.gif" width="44" height="39" border="0" alt="ePrints home" /></td>
<td><a href="/" onMouseOut="MM_swapImgRestore()" onMouseOver="MM_swapImage('ePrints_banner_r6_c4','','/images/eprints/ePrints_banner_r6_c4_f2.gif',1);"><img name="ePrints_banner_r6_c4" src="/images/eprints/ePrints_banner_r6_c4.gif" width="105" height="24" border="0" alt="ePrints home" /></a></td>
<td><img src="/images/eprints/spacer.gif" width="1" height="24" border="0" alt="" /></td>
</tr>
<tr>
<td><img name="ePrints_banner_r7_c2" src="/images/eprints/ePrints_banner_r7_c2.gif" width="104" height="15" border="0" alt="" /></td>
<td colspan="8"><img name="ePrints_banner_r7_c4" src="/images/eprints/ePrints_banner_r7_c4.gif" width="517" height="15" border="0" alt="" /></td>
<td><img src="/images/eprints/spacer.gif" width="1" height="15" border="0" alt="" /></td>
</tr>
</table></td>
</tr>
<tr><td><table width="100%" style="font-size: 90%; border: solid 1px #ccc; padding: 3px"><tr>
<td align="left"><a href="http://eprints.utas.edu.au/cgi/users/home">Login</a> | <a href="http://eprints.utas.edu.au/cgi/register">Create Account</a></td>
<td align="right" style="white-space: nowrap">
<form method="get" accept-charset="utf-8" action="http://eprints.utas.edu.au/cgi/search" style="display:inline">
<input class="ep_tm_searchbarbox" size="20" type="text" name="q" />
<input class="ep_tm_searchbarbutton" value="Search" type="submit" name="_action_search" />
<input type="hidden" name="_order" value="bytitle" />
<input type="hidden" name="basic_srchtype" value="ALL" />
<input type="hidden" name="_satisfyall" value="ALL" />
</form>
</td>
</tr></table></td></tr>
<tr>
<td class="toplinks"><!-- InstanceBeginEditable name="content" -->
<div align="center">
<table width="720" class="ep_tm_main"><tr><td align="left">
<h1 class="ep_tm_pagetitle">Emerging technologies in hemostasis diagnostics: A report from the Australasian Society of Thrombosis and Haemostasis Emerging Technologies Group</h1>
<p style="margin-bottom: 1em" class="not_ep_block"><span class="person_name">Adams, M.J.</span> and <span class="person_name">Ward, C.</span> and <span class="person_name">Thom, J.</span> and <span class="person_name">Bianchi, A.</span> and <span class="person_name">Perrin, E.</span> and <span class="person_name">Coghlan, D.</span> and <span class="person_name">Smith, M.</span> (2007) <xhtml:em>Emerging technologies in hemostasis diagnostics: A report from the Australasian Society of Thrombosis and Haemostasis Emerging Technologies Group.</xhtml:em> Seminars in Thrombosis and Hemostasis, 33 (3). pp. 226-234. ISSN 0094-6176</p><p style="margin-bottom: 1em" class="not_ep_block"></p><table style="margin-bottom: 1em" class="not_ep_block"><tr><td valign="top" style="text-align:center"><a href="http://eprints.utas.edu.au/1773/1/Adams_etal_2007_(ASTH).pdf"><img alt="[img]" src="http://eprints.utas.edu.au/style/images/fileicons/application_pdf.png" class="ep_doc_icon" border="0" /></a></td><td valign="top"><a href="http://eprints.utas.edu.au/1773/1/Adams_etal_2007_(ASTH).pdf"><span class="ep_document_citation">PDF</span></a> - Full text restricted - Requires a PDF viewer<br />104Kb</td><td><form method="get" accept-charset="utf-8" action="http://eprints.utas.edu.au/cgi/request_doc"><input accept-charset="utf-8" value="2253" name="docid" type="hidden" /><div class=""><input value="Request a copy" name="_action_null" class="ep_form_action_button" onclick="return EPJS_button_pushed( '_action_null' )" type="submit" /> </div></form></td></tr></table><p style="margin-bottom: 1em" class="not_ep_block">Official URL: <a href="http://dx.doi.org/10.1055/s-2007-971808">http://dx.doi.org/10.1055/s-2007-971808</a></p><div class="not_ep_block"><h2>Abstract</h2><p style="padding-bottom: 16px; text-align: left; margin: 1em auto 0em auto">Technology in hemostasis laboratories has evolved enormously during the last
30 years. Although many scientists and clinicians will remember the traditional tilt-tube
techniques to screen for coagulation abnormalities and to monitor anticoagulant therapy,
the hemostasis laboratory today uses a variety of modern technologies. These include flow
cytometry, chromogenic assays, molecular typing (e.g., polymerase chain reaction), immunologic
assays (e.g., enzyme-linked immunosorbent assays), functional assays of specific
coagulation proteins, and platelet function analyzers. Although these advances in technology
have resulted in greater capability, productivity, sensitivity, specificity, and ultimately,
improvement in the clinical care of patients, controversies and limitations remain.
This article highlights new and emerging technologies in hemostasis and discusses whether
they have improved or are likely to improve laboratory diagnostics by specifically addressing
the following: (1) Can new technologies help predict likelihood of thrombosis recurrence?
(2) Has an understanding of the role of a disintegrin-like and metalloprotease with
thrombospondin type 1 motifs (ADAMTS13) in microangiopathy resulted in improved
diagnostic methods for this disorder? (3) Does thrombelastography allow better definition
of bleeding risk than conventional hemostasis assays, especially in settings of acute
hemostatic pathology?</p></div><table style="margin-bottom: 1em" cellpadding="3" class="not_ep_block" border="0"><tr><th valign="top" class="ep_row">Item Type:</th><td valign="top" class="ep_row">Article</td></tr><tr><th valign="top" class="ep_row">Additional Information:</th><td valign="top" class="ep_row">Copyright 2007, Georg Thieme Verlag. Definitive version is available online at http://www.thieme-connect.de/ejournals/toc/sth/6268</td></tr><tr><th valign="top" class="ep_row">Keywords:</th><td valign="top" class="ep_row">Hemostasis, laboratory testing, thrombin generation, thrombophilia, bleeding</td></tr><tr><th valign="top" class="ep_row">Subjects:</th><td valign="top" class="ep_row"><a href="http://eprints.utas.edu.au/view/subjects/321008.html">320000 Medical and Health Sciences > 321000 Clinical Sciences > 321008 Haematology</a></td></tr><tr><th valign="top" class="ep_row">ID Code:</th><td valign="top" class="ep_row">1773</td></tr><tr><th valign="top" class="ep_row">Deposited By:</th><td valign="top" class="ep_row"><span class="ep_name_citation"><span class="person_name">Dr Murray J Adams</span></span></td></tr><tr><th valign="top" class="ep_row">Deposited On:</th><td valign="top" class="ep_row">12 Sep 2007</td></tr><tr><th valign="top" class="ep_row">Last Modified:</th><td valign="top" class="ep_row">09 Jan 2008 02:30</td></tr><tr><th valign="top" class="ep_row">ePrint Statistics:</th><td valign="top" class="ep_row"><a target="ePrintStats" href="/es/index.php?action=show_detail_eprint;id=1773;">View statistics for this ePrint</a></td></tr></table><p align="right">Repository Staff Only: <a href="http://eprints.utas.edu.au/cgi/users/home?screen=EPrint::View&eprintid=1773">item control page</a></p>
</td></tr></table>
</div>
<!-- InstanceEndEditable --></td>
</tr>
<tr>
<td><!-- #BeginLibraryItem "/Library/footer_eprints.lbi" -->
<table width="795" border="0" align="left" cellpadding="0" class="footer">
<tr valign="top">
<td colspan="2"><div align="center"><a href="http://www.utas.edu.au">UTAS home</a> | <a href="http://www.utas.edu.au/library/">Library home</a> | <a href="/">ePrints home</a> | <a href="/contact.html">contact</a> | <a href="/information.html">about</a> | <a href="/view/">browse</a> | <a href="/perl/search/simple">search</a> | <a href="/perl/register">register</a> | <a href="/perl/users/home">user area</a> | <a href="/help/">help</a></div><br /></td>
</tr>
<tr><td colspan="2"><p><img src="/images/eprints/footerline.gif" width="100%" height="4" /></p></td></tr>
<tr valign="top">
<td width="68%" class="footer">Authorised by the University Librarian<br />
© University of Tasmania ABN 30 764 374 782<br />
<a href="http://www.utas.edu.au/cricos/">CRICOS Provider Code 00586B</a> | <a href="http://www.utas.edu.au/copyright/copyright_disclaimers.html">Copyright & Disclaimers</a> | <a href="http://www.utas.edu.au/accessibility/index.html">Accessibility</a> | <a href="http://eprints.utas.edu.au/feedback/">Site Feedback</a> </td>
<td width="32%"><div align="right">
<p align="right" class="NoPrint"><a href="http://www.utas.edu.au/"><img src="http://www.utas.edu.au/shared/logos/unioftasstrip.gif" alt="University of Tasmania Home Page" width="260" height="16" border="0" align="right" /></a></p>
<p align="right" class="NoPrint"><a href="http://www.utas.edu.au/"><br />
</a></p>
</div></td>
</tr>
<tr valign="top">
<td><p> </p></td>
<td><div align="right"><span class="NoPrint"><a href="http://www.eprints.org/software/"><img src="/images/eprintslogo.gif" alt="ePrints logo" width="77" height="29" border="0" align="bottom" /></a></span></div></td>
</tr>
</table>
<!-- #EndLibraryItem -->
<div align="center"></div></td>
</tr>
</table>
</body>
</html>
