/library/oar/handle/123456789/484 2026-11-05T06:31:02Z /library/oar/handle/123456789/150573 Title: Haemostasis in kidney failure Authors: Caruana, Jessica; Riva, Nicoletta; Gatt, Alexander Abstract: Introduction to the pathophysiology of haemostasis in kidney failure The haemostatic system is a finely balanced biological mechanism that maintains an equilibrium between the procoagulant and anticoagulant pathways. This complex system is dynamic, whereby the procoagulant pathway is set in motion in cases of vascular injury to ensure haemostasis, while the anticoagulant pathway prevents excessive blood clotting (thrombosis). Kidney failure (KF), that is the final and permanent stage of chronic kidney disease (CKD), knocks this delicate balance out of kilter, making KF patients susceptible to both thrombotic and bleeding episodes. The pathophysiology of this paradox is intricate and multifactorial. Increased thrombotic risks are attributed to chronic inflammation and endothelial cell damage, whereas bleeding tendencies are associated with primary haemostatic interferences and anaemia of chronic disease3. Risks of thromboembolic complications tend to be exacerbated in KF due to accompanying comorbidities such as cardiovascular disease (CVD) and diabetes mellitus (DM). CKD is a persistent and progressive condition affecting more than 850 million individuals worldwide4. Kidney Disease Improving Global Outcomes (KDIGO) guidelines define KF as aglomerularfiltration rate (GFR)that is less than 15 ml/min/1.73 m2. At this stage patients are typically required to undergo long-term dialysis treatment or kidney transplantation. 2025-01-01T00:00:00Z /library/oar/handle/123456789/150554 Title: Management diagnostico-terapeutico delle trombosi venose in siti inusuali Authors: Caiano, Lucia; Riva, Nicoletta; Ageno, Walter Abstract: Le trombosi venose cerebrali possono interessare una o piu vene del distretto cerebrale (comprendente sia le vene corticali sia le vene cerebrali profonde), oppure i seni venosi della dura madre (seno sagittale superiore, seni laterali o trasversi, seno retto, seno sigmoideo, seno cavernoso). A seconda della sede interessata e dell'estensione della trombosi, le manifestazioni cliniche saranno differenti. Le sedi piu spesso coinvolte sono il seno sagittale superiore (fino al 62% dei casi), i seni trasversi (40-45%), il seno retto (18%) e le vene corricali (17%). In circa due terzi dei pazienti puo essere coinvolto piu di un seno venoso. La diagnosi puo essere difficoltosa e tardiva perche i segni e i sintomi possono mimare le manifestazioni di altre patologie cerebrali. La prognosi puo essere severa, mentre complessivamente le recidive non sono frequenti. 2024-01-01T00:00:00Z /library/oar/handle/123456789/150533 Title: “The ISTH SSC subcommittee on hemostatic management of patients with liver disease : goals, ambitions, and call for collaboration” : reply Authors: Lisman, Ton; Carlin, Stephanie; Gatt, Alexander; Hernandez-Gea, Virginia; Luyendyk, James P.; Roberts, Lara N.; Stanworth, Simon J. Abstract: We thank Tripodi and Mannucci for their interest in our recent editorial, in which we introduce the International Society on Thrombosis and Haemostasis Scientific and Standardization Committee (SSC) on Hemostatic Management of Patients with Liver Disease. We share their enthusiasm regarding the support of ISTH for this topic and agree that the thrombosis and hemostasis community recognized the relevance of this topic somewhat later than other communities. Indeed, international societies on hepatology, anesthesia, and surgery have had this topic on their agendas for a number of years. We are very glad to bring the expertise of the thrombosis and hemostasis community to the forefront of this effort through the newly established SSC subcommittee. 2023-01-01T00:00:00Z /library/oar/handle/123456789/150284 Title: A comparative in vitro study of the anticoagulant effects of branded versus biosimilar preparations of enoxaparin Authors: Sammut, Luca; Vella, Kevin; Kitchen, Steve; Hickey, Kieron; Borg-Aquilina, Denise; Gatt, Alexander; Riva, Nicoletta Abstract: Several biosimilars of the low-molecular-weight heparin enoxaparin are available on the market, but no studies have compared the effects of branded versus biosimilar enoxaparin on coagulation assays. The aim of this study was to compare the in vitro anticoagulant effects of the branded enoxaparin (Clexane) and three biosimilar versions (Critinox, Inhixa, and Qnox) on a panel of coagulation assays. A platelet-poor plasma pool was spiked with five concentrations of four different enoxaparins (range 0.2–2.0 IU/mL). These were measured using the chromogenic anti-Xa assay and chromogenic anti-IIa assay. The following coagulation assays were performed in duplicates for each enoxaparin preparation: prothrombin time (PT), activated partial thromboplastin time (aPTT), PT-derived fibrinogen, Clauss fibrinogen, thrombin time (TT), dilute Russell's viper venom time (dRVVT) screen and confirm, one-stage factors VII, VIII, and IX, and chromogenic assays for factors VIII and IX. Positive correlations were observed between increasing concentrations of the different enoxaparins and PT, aPTT, TT, and dRVVT screen and confirm. Negative correlations were observed with all one-stage factor assays and chromogenic FVIII. No consistent correlation was observed for the fibrinogen assays and chromogenic FIX. All enoxaparin preparations had an estimated mean anti-Xa:anti-IIa activity ratio between 3.12:1 and 3.92:1. There were no statistically significant differences between the four preparations of enoxaparin. This study showed that branded and biosimilar versions of enoxaparin exhibited very similar in vitro anticoagulant effects across the coagulation assay panel tested. 2026-01-01T00:00:00Z