The platelet thrombin receptor and postoperative bleeding

Victor A. Ferraris, Suellen P. Ferraris, Amandeep Singh, Wendy Fuhr, Darren Koppel, Daniel McKenna, Evelio Rodriguez, Herbert Reich

    Research output: Contribution to journalArticle

    66 Citations (Scopus)

    Abstract

    Background. We hypothesized that small amounts of thrombin desensitize the platelet thrombin receptor during cardiopulmonary bypass (CPB), resulting in postoperative platelet dysfunction and bleeding. Methods. Seventy-nine patients were entered into a study designed to measure changes in platelet thrombin receptor function during CPB and to correlate them to postoperative bleeding. In addition to measurements of clinical blood loss, platelet function tests of aggregation, activation, and cell-cell adhesion were used. The thrombin receptor agonist peptide (TRAP) was used to activate the platelets. Flow cytometry was used to measure various platelet surface markers and platelet-white cell interactions during CPB. Results. Compared with preoperative values, both aggregometry and flow cytometry measured a significant reduction of TRAP-induced activation immediately and up to 24 hours after CPB. The response of other activating agents returned to normal by 24 hours. Postoperatively, 8 of 79 patients required excessive blood transfusion (≤ 10 units of blood products) and had significantly decreased TRAP-induced aggregation response. Conclusions. Our results show that (1) platelet activation, aggregation, and adhesion to leukocytes induced by TRAP are reduced after CPB, (2) decreased thrombin receptor responsiveness is associated with excessive postoperative blood loss, and (3) because the aggregation and activation responses are different for TRAP and thrombin, there may be a second thrombin receptor on platelets that is protected from damage during CPB. These results imply that prevention of the CPB-induced effects on the thrombin receptor will lessen postoperative morbidity associated with blood transfusion.

    Original languageEnglish (US)
    Pages (from-to)352-358
    Number of pages7
    JournalAnnals of Thoracic Surgery
    Volume65
    Issue number2
    DOIs
    StatePublished - Jan 1 1998

    Fingerprint

    Thrombin Receptors
    Blood Platelets
    Cardiopulmonary Bypass
    Hemorrhage
    Peptides
    Thrombin
    Blood Transfusion
    Flow Cytometry
    Platelet Function Tests
    Postoperative Hemorrhage
    Cell Aggregation
    Platelet Activation
    Platelet Aggregation
    Cell Adhesion
    Cell Communication
    Leukocytes

    All Science Journal Classification (ASJC) codes

    • Surgery
    • Pulmonary and Respiratory Medicine
    • Cardiology and Cardiovascular Medicine

    Cite this

    Ferraris, V. A., Ferraris, S. P., Singh, A., Fuhr, W., Koppel, D., McKenna, D., ... Reich, H. (1998). The platelet thrombin receptor and postoperative bleeding. Annals of Thoracic Surgery, 65(2), 352-358. https://doi.org/10.1016/S0003-4975(97)01348-9

    The platelet thrombin receptor and postoperative bleeding. / Ferraris, Victor A.; Ferraris, Suellen P.; Singh, Amandeep; Fuhr, Wendy; Koppel, Darren; McKenna, Daniel; Rodriguez, Evelio; Reich, Herbert.

    In: Annals of Thoracic Surgery, Vol. 65, No. 2, 01.01.1998, p. 352-358.

    Research output: Contribution to journalArticle

    Ferraris, VA, Ferraris, SP, Singh, A, Fuhr, W, Koppel, D, McKenna, D, Rodriguez, E & Reich, H 1998, 'The platelet thrombin receptor and postoperative bleeding', Annals of Thoracic Surgery, vol. 65, no. 2, pp. 352-358. https://doi.org/10.1016/S0003-4975(97)01348-9
    Ferraris VA, Ferraris SP, Singh A, Fuhr W, Koppel D, McKenna D et al. The platelet thrombin receptor and postoperative bleeding. Annals of Thoracic Surgery. 1998 Jan 1;65(2):352-358. https://doi.org/10.1016/S0003-4975(97)01348-9
    Ferraris, Victor A. ; Ferraris, Suellen P. ; Singh, Amandeep ; Fuhr, Wendy ; Koppel, Darren ; McKenna, Daniel ; Rodriguez, Evelio ; Reich, Herbert. / The platelet thrombin receptor and postoperative bleeding. In: Annals of Thoracic Surgery. 1998 ; Vol. 65, No. 2. pp. 352-358.
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