HAEMOSTASIS
Automated thrombin generation offers insights to peritoneal cancer study
Use of thrombin generation testing to measure the coagulation profile of patients undergoing surgery to assess their bleeding risk could lead to major improvements in managing intraoperative bleeding. Here, Stago reports on its involvement in surgical research into pseudomyxoma peritonei.
A Welsh scientist is using her understanding of thrombin generation in haemostasis and its role in critical bleeding assessment to lead a major clinical research project into pseudomyxoma peritonei, a rare
abdominal cancer. Further, she has chosen the automated thrombin generation (TG) assay delivered by Stago’s ST Genesia to assess bleeding and help evaluate the effectiveness of different treatment options.
Dr Sophia Stanford is lead research scientist at the internationally renowned Peritoneal Malignancy Institute Basingstoke, part of the Hampshire Hospitals NHS Foundation Trust.1
The
institute specialises in the surgical treatment of patients with peritoneal cancer that has spread to the lining the abdominal wall and the tissues covering the organs. Basingstoke and Manchester’s Christie Hospital are the UK’s only two centres of excellence funded by the NHS to carry out ‘highly specialised services’ into this cancer.
The team, of which Dr Stanford is part, has initiated a phase three clinical trial involving the ST Genesia to help investigate the use of fibrinogen concentrate versus the standard use of cryoprecipitate in managing intraoperative bleeding. Dr Stanford was also previously involved in a similar stage 2 study, focusing on managing intraoperative bleeding, and whether patients would benefit from receiving fibrinogen concentrate.2
The new trial
takes this one step further. Thrombin generation testing, in addition to other coagulation factors, is being used to measure the haemostasis status of patients undergoing invasive surgery while they are receiving different fibrinogen products.
Computed tomography scan of abdomen showing pseudomyxoma peritonei with multiple peritoneal masses (arrows).
WWW.PATHOLOGYINPRACTICE.COM FEBRUARY 2022
Value of pathology As Dr Stanford explained “The only way to treat patients with advanced forms of this very unusual cancer is with major invasive surgery – and it is essential that we explore new ways of managing intraoperative bleeding. Fibrinogen is the first coagulation factor to become critically reduced, so rapid supplementation to restore physiological plasma levels is important in helping to regain haemostasis in these bleeding patients.
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Li C, Kanthan R, Kanthan SC
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