Undiagnosed Thrombocytopenia

From an anonymous inquirer: I have been misdiagnosed for years. I have very large and oval-shaped platelets which my average count is 40,000. I also tell whoever is taking my complete blood count (CBC) to make sure it is a manual count because my platelets are too large for the machine. I have great coagulation […]

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Bleeding Disorders

Feb 1 2012

george

PRP Gel, Platelet Substitute

Another interesting discussion from our UMDNJ graduate Hemostasis course: About 6 years back, I caught wind of a discussion regarding platelet substitutes, which I found quite intriguing. I did some digging as a result of this discussion and am amazed by the potential of such technologies. It appears that platelet rich plasma (PRP) gel has been around […]

Bleeding Disorders

Ristocetin Cofactor

Laura Lum, Seattle Children’s Hospital, asks, What is the ristocetin cofactor assay for, how is it performed, and can it be done on an STA Compact? Hi, Laura, the ristocetin cofactor assay is a test for von Willebrand factor (VWF) activity. Low VWF is the cause of von Willebrand disease (VWD). The assay began as platelet aggregometry […]

Bleeding Disorders

New Ristocetin Lot and Storage Requirements

We’ve had two questions about Ristocetin since our 11.9.11 Problems with Ristocetin question from Kerri Klemm. Kerri’s question prompted me to contact Kathy Jacobs at Chrono-log Corp, a major distributor of ristocetin in the US and around the world. Here is a follow-up message from Kathy: Hello George, Nice to hear from you and a very happy New Year to you and your family. As […]

Bleeding Disorders

Adapting Ristocetin Cofactor Assay Reagent

Has anyone been able to adapt a third-party reagent for ristocetin onto a Stago STAR-E or Compact? If so, would you be willing to share your experience with the product, validation procedure, etc? Please feel free to reply off-line if you so desire, and thank you in advance, Dorothy Zdanowicz, Chemistry/Coagulation Supervisor Englewood Hospital & […]

Bleeding Disorders

Acceptable Interval for VWF:RCo

George, Our lab participates in both CAP CGE and NASCOLA ECAT proficiency challenges. One of those assays, von Willebrand factor ristocetin cofactor (VWF:RCo) activity by the agglutination method, is difficult to judge in terms of performance. When looking at results, what is acceptable for criteria? I usually look for ±2 SD for other tests. Sometimes […]

Bleeding Disorders

More on AB Plasma to Correct Bleeding

Jose DeJesus‘ November 9 question about providing plasma to an AB patientbecame a dinner-table discussion at my house. You may think, “What a sad, dull existence–a two-MLS family,” however, we’ve turned up some interesting information by communicating with acquaintances at three institutions. First, if you can give incompatible platelet concentrate, why not incompatible plasma? There are […]

Bleeding Disorders

AB Plasma to Correct Bleeding

George spoke with Jose DeJesus, MS, MLS, transfusion service manager for DCH Regional Medical Center in Tuscaloosa, Alabama. In the past year, Jose has managed three warfarin overdose patients with acute hemorrhage who were blood group AB. The worldwide prevalence of group AB is 5.6%, and despite special AB plasma donor programs, AB donor plasma is in chronic short supply. AB […]

Bleeding Disorders

NW Medical Lab Symposium Oct 12–15

The Northwest Medical Laboratory Symposium is planned for October 12–15 in the Lynnwood Convention Center, Lynnwood Washington, just north of Seattle. On Friday, October 14, George will speak on “Hemophilia Therapy: From Rasputin to Recombinants,”8:30–10, and “The Top Ten Problems in the Coagulation Laboratory,” 2–3:30. The handouts for these presentations are available for registrants from the NWMLS web site, and are also […]

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Anticoagulant Therapy

Oct 11 2011

george

Post-partum Hemorrhage and Component Therapy

Hi George! As always, I enjoy this educational resource very much! My question is: Why do healthy women who experience post-partum hemorrhage (PPH) seem to “autocorrect” their coagulopathy with very little help from component therapy? I have noted that once the bleeding site has been tended to, the patient requires relatively little support with factor/fibrinogen […]

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Bleeding Disorders

Bleeding Disorders

Undiagnosed Thrombocytopenia

PRP Gel, Platelet Substitute

Ristocetin Cofactor

New Ristocetin Lot and Storage Requirements

Adapting Ristocetin Cofactor Assay Reagent

Acceptable Interval for VWF:RCo

More on AB Plasma to Correct Bleeding

AB Plasma to Correct Bleeding

NW Medical Lab Symposium Oct 12–15

Post-partum Hemorrhage and Component Therapy

George Fritsma MS MLS

Cheat Sheets from George

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