Haematologica 2004;89: supplement no. 8 - Supplements ...

XVIII Congress of the Italian Society for Hemostasis and Thrombosis Research, Rome, Sept. 30-Oct. 3, 2004163plasma levels >15 µmol/L; 32.5% vs. 33.0%) and ofdiabetes mellitus (6.6% vs. 3.6%) did not differ fromcontrols. In conclusion some established cardiovascularrisk factor (hypertension, hypercholesterolemiaand overweight/obesity) may have a role in VTE, suggestingthat treatment and/or prophylaxis of theseconditions may contribute to primary and secondaryprevention of VTE.PO-135TISSUE FACTOR PATHWAY INHIBITOR (TFPI) AND THROMBINACTIVABLE FIBRINOLYSIS INHIBITOR (TAFI) IN JUVENILE DEEPVEIN THROMBOSISRogolino A,* Cellai AP,* Blagojevich J, Marcucci R,Gori AM, Cesari F, Lenti M, Sestini I, Abbate R,Gensini GF, Prisco DDepartment of Medical and Surgical Critical Area,University of Florence, Florence, Italy; *Dipartimentodel Cuore e dei Vasi, Azienda OspedalieraUniversitaria CareggiLow levels of tissue factor pathway inhibitor (TFPI)and elevated levels of thrombin activatable fibrinolysisinhibitor (TAFI) have been recently reported to beassociated with an increased risk of deep venousthrombosis (DVT). Scarce data are available on therole of these parameters in juvenile DVT. We investigated116 patients with a first episode of DVT before50 years (median age 38, 17-50 yrs; 51 males/65females) and 60 apparently health subjects comparablefor age and sex. TFPI and TAFI plasma levels weremeasured by ELISAs (Asserachrom total- and free-TFPI, Diagnostica Stago; Asniere sur Seine, France;COALIZA TAFI, Chromogenix, IL, Milan, Italy). Venousblood samples were collected at least 6 months afterthe acute event. No patient was under anticoagulanttreatment for at least three months. Free-TFPI plasmalevels were not significantly different betweenpatients and controls (10.7, 7-28.2 ng/mL vs 11.5, 5.6-48.7 ng/mL). Ten percent of healthy subjects had TFPIfree antigen levels below 7.1 ng/mL (10 th percentile).A similar percentage (10.3%) of patients had free-TFPI below this cut-off. Total-TFPI plasma levels werenot significantly different between patients and controlsalthough a trend to higher levels was observedin patients (78.6, 42.7-190.9 ng/mL vs 69.8, 42.1-198.1 ng/mL). Ten percent of healthy subjects had TFPItotal antigen levels below 51.2 ng/mL (10th percentile).A similar percentage (7.5%) of patients hadtotal-TFPI below this cut-off. As TAFI plasma levels areconcerned, no significant differences were foundbetween patients and controls (103, 47.6-262.9% vs102, 57-233%). Ten out of 116 DVT patients (8.6%)had TAFI levels above 90 th percentile of control distribution(150.4%). These preliminary results do not supporta relevant role for TFPI defect and TAFI excess injuvenile DVT. Further studies are needed on a largernumber of patients and healthy controls to betterassess the utility of their determination in the clinicalmanagement of patients with DVT.PO-136USE OF BLOOD SALVAGE AND RE-INFUSION IN PATIENTSUNDERGOING TOTAL HIP ARTHROPLASTY AND TOTALKNEE ARTHROPLASTY AND POSSIBLE CORRELATION WITHVTE COMPLICATIONSFilippucci E,* Agnelli G,* Gallus AS,° Kuznetsova P, §Anderson FA Jr § for The Glory Investigators*Dipartimento di Medicina Interna, Università diPerugia, Perugia, Italia; °Flinders Medical Centre,Bedford Park, South Australia, Australia; § Centerfor outcomes research, University of MassachusettsMedical School, Worcester, MA, USAIntroduction: In patients undergoing major orthopedicsurgery, the risk of viral transmission associatedwith blood transfusion promoted the developmentof perioperative blood salvage and other alternativesto donor blood transfusion. Recent data suggestthat perioperative salvage and re-infusion ofunwashed whole blood is associated with an activationof blood coagulation in patients undergoingtotal knee arthroplasty (TKA). We analysed the use oftransfusion and blood re-infusion in patients undergoingTKA and total hip arthroplasty (THA). Methods:Patients undergoing THA or TKA between January2002 and December 2003 in 68 hospitals located in11 countries were enrolled in the GLORY registry. TheGLORY registry is a large prospective study on theoutcome of patients undergoing major orthopedicsurgery. Data on VTE events were collected aftersurgery and at 3 months following the hospital discharge.Results: Of 4995 patients, 2364 (47.3%)underwent THA and 2631 (52.7%) underwent TKA.Blood salvage was used in about one fourth ofpatients (26%), and its diffusion is higher in USA incomparison to non-USA countries (37% vs 16%,respectively). Among blood salvage procedures, postoperativere-infusion is the most used (postoperative14.8%, intraoperative 1.0%, both 9.5%). Unwashedblood is the re-infusion procedure most largerly usedin USA, in comparison to washed blood (93.9% vs5.8%), while in the non-USA countries the use ofthe unwashed and washed devices is quite similar(43.3% vs 39.8% respectively). 64% of THA and 59%of TKA patients received LMWH as VTE prophylaxis.Conclusion: Re-infusion procedures are frequentlyused in patients undergoing THA and TKA. No dataare currently available about the incidence of venousthromboembolism in patients undergoing perioper-haematologica vol. 89(suppl. n. 8):september 2004