ArticleJournal of thrombosis and haemostasis : JTH2022
Thrombus formation during ECMO: Insights from a detailed histological analysis of thrombus composition.
Article in Journal of thrombosis and haemostasis : JTH, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed, 50 citations in OpenAlex.
- Challenges and opportunities in ECMO monitoring: A mixed-methods appraisal.The journal of extra-corporeal technology · 2026Review
- Multimodal characterization of flow-induced thrombus initiation and growth in extracorporeal membrane oxygenation.Scientific reports · 2026Article
- Computational analysis of haemodynamics and oxygen distribution in the patient-specific aorta during VA-ECMO under various clinical scenarios.Medical & biological engineering & computing · 2026Article
- Platelets as Central Modulators of Post-Cardiac Arrest Syndrome: Mechanisms and Therapeutic Implications.Biomolecules · 2026Review
- Polymer embedding of membrane lungs for histological investigations of intra-device clot formation.Frontiers in cardiovascular medicine · 2026Article
- Automated deep learning based detection of cellular deposits on clinically used ECMO membrane lungs.Frontiers in bioinformatics · 2026Article
- Characterization of PEG-Modified Composite Membranes for Microfluidic Oxygenator Applications.Micromachines · 2025Article
- The Impact of Venovenous Extracorporeal Membrane Oxygenation Cannulation Configuration on Hemodynamic Characteristics and Risks of Hemolysis.Annals of biomedical engineering · 2025Article
- Material-Induced Platelet Adhesion/Activation and Hemolysis of Membrane Lung Components from Extracorporeal Membrane Oxygenation.Biomedicines · 2025Article
- Progress of extracorporeal centrifugal pumps for mechanical circulatory supports.Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs · 2025Review
- Free floating thrombus in the ascending aorta after extracorporeal cardiopulmonary resuscitation: a case series.European heart journal. Case reports · 2025Article
- Red Blood Cell-Induced Bacterial Margination Improves Microbial Hemoadsorption on Engineered Cell-Depleted Thrombi, Restoring Severe Bacteremia in Rats.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Article
- CELL FREE DNA-BASED PREDICTION OF PROGNOSIS FOR PATIENTS ON VENO-ARTERIAL EXTRACORPOREAL MEMBRANE OXYGENATION.Shock (Augusta, Ga.) · 2025Article
- ECMO-induced coagulopathy: strategic initiatives for research and clinical practice (a workshop report of the NHLBI).Blood vessels, thrombosis & hemostasis · 2025Review
- A Universal and Versatile Zwitterionic Coating for Blood-Contacting Catheters with Long Lengths and Complex Geometries.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Article
- Tougher clots, safer lives? Revisiting the role of factor XIII in thrombus stability and embolization risk.Research and practice in thrombosis and haemostasis · 2025Article
- Platelet Adhesion and Activation in an ECMO Thrombosis-on-a-Chip Model.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2024Article
- Risk factors for elective and emergency oxygenator exchanges during veno-venous extracorporeal membrane oxygenation.Perfusion · 2024Observational
- Comparison of bleeding and thrombotic outcomes in veno-venous extracorporeal membrane oxygenation: Heparin versus bivalirudin.European journal of haematology · 2024Article
- Anticoagulation Management in V-V ECMO Patients: A Multidisciplinary Pragmatic Protocol.Journal of clinical medicine · 2024Review
Corrections and comments
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Authors and funding
20 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesIntra-device thrombosis remains one of the most common complications during extracorporeal membrane oxygenation (ECMO). Despite anticoagulation, approximately 35% of patients develop thrombi in the membrane oxygenator, pump heads, or tubing. The aim of this study was to describe the molecular and cellular features of ECMO thrombi and to study the main drivers of thrombus formation at different sites in the ECMO circuits. APPROACH AND
resultsThrombi (n = 85) were collected immediately after veno-arterial-(VA)-ECMO circuit removal from 25 patients: 23 thrombi from the pump, 25 from the oxygenator, and 37 from the tubing. Quantitative histological analysis was performed for the amount of red blood cells (RBCs), platelets, fibrin, von Willebrand factor (VWF), leukocytes, and citrullinated histone H3 (H3Cit). ECMO thrombi consist of a heterogenous composition with fibrin and VWF being the major thrombus components. A clustering analysis of the four major histological parameters identified two typical thrombus types: RBC-rich and RBC-poor/fibrin-rich thrombi with no significant differences in VWF and platelet content. Thrombus composition was not associated with the thrombus location, except for higher amounts of H3Cit that were found in pump and oxygenator thrombi compared to tubing samples. We observed higher blood leukocyte count and lactate dehydrogenase levels in patients with fibrin-rich thrombi.
conclusionWe found that thrombus composition is heterogenous, independent of their location, consisting of two types: RBC-rich and a fibrin-rich types. We also found that NETs play a minor role. These findings are important to improve current anticoagulation strategies in ECMO.
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