To study the effect of FFP transfusion on the hemostatic status of patients with liver disease, we performed thrombomodulin‐modified thrombin generation assays in platelet‐poor plasma using the fluorimetric method as described by Hemker et al.23 We used commercially available reagents (FluCa‐kit TS50.00, Thrombin Calibrator TS20.00, PPP reagent; Thrombinoscope, Maastricht, The Netherlands) containing recombinant tissue factor (final concentration, 5 pM), and phospholipids (final concentration, 4 μM) and soluble thrombomodulin (TS70.00, concentration not disclosed by manufacturer). Experiments were performed following protocols provided by the manufacturer.
Additional conventional coagulation tests, more specifically APTT, INR, factor II, and antithrombin activity, were performed using the StaCompact 3 (Stago, Breda, the Netherlands) using reagents and instructions from the manufacturer. Fibrinogen levels in plasma were determined using a Clauss fibrinogen assay on the ACL top 300 from Instrumentation laboratories (Werfen, Breda, the Netherlands) using the manufacturer's reagents and instructions.
Additional conventional coagulation tests, more specifically APTT, INR, factor II, and antithrombin activity, were performed using the StaCompact 3 (Stago, Breda, the Netherlands) using reagents and instructions from the manufacturer. Fibrinogen levels in plasma were determined using a Clauss fibrinogen assay on the ACL top 300 from Instrumentation laboratories (Werfen, Breda, the Netherlands) using the manufacturer's reagents and instructions.