ORIGINAL ARTICLESThe effects of glycosaminoglycans on coagulation: a thromboelastographic studySenzolo, Ma,d; Coppell, Jb; Cholongitas, Ea; Riddell, Ab; Triantos, CKa; Perry, Dc; Burroughs, AKaAuthor Information aLiver Transplantation and Hepatobiliary Unit, UK bHaemophilia Centre & Haemostasis Unit, UK cRoyal Free Hospital, London, UK dGastroenterology, Department of Surgical and Gastroenterological Sciences, University-Hospital of Padua, Padua, Italy Received 27 May, 2006 Accepted 18 July, 2006 Correspondence and requests for reprints to Prof. Andrew K. Burroughs, Liver Transplantation and Hepatobiliary Unit, Royal Free Hospital, Pond Street, London NW3 2QG, UK Tel: +44 20 7472 6229; fax: +44 20 7472 6226; e-mail: email@example.com Blood Coagulation & Fibrinolysis: April 2007 - Volume 18 - Issue 3 - p 227-236 doi: 10.1097/MBC.0b013e328010bd3d Buy Metrics Abstract Endogenous heparinoids impair coagulation, evidenced by thrombelastography in cirrhotic patients with bacterial infection, but it is not clear which glycosaminoglycans can be detected by native and heparinase-modified thrombelastography. To assess the effects of different glycosaminoglycans on thrombelastography parameters and the reversibility of these effects by heparinase-I-modified thrombelastography. Twenty volunteers were enrolled. Solutions of heparan sulphate, dermatan sulphate, and chondroitin-4-sulphate were prepared at ‘equivalent’ concentrations, based on the composition and anticoagulant activity of danaparoid. Serial dilutions of each glycosaminoglycan were prepared to achieve 1.0, 0.5, 0.1, and 0.05 U/ml. Native and heparinase-modified thrombelastography, anti-activated factor X activity and heparin cofactor II activity were evaluated at each concentration. A statistically significant heparin-like effect was seen with 1 and 0.5 U/ml heparan sulphate, and 1 and 0.5 U/ml dermatan sulphate, which was completely reversed by heparinase-modified thrombelastography. Anti-activated factor X activity was significantly increased in samples containing heparan and dermatan sulphates. The heparin cofactor II activity decreased with 1.0 and 0.5 U/ml dermatan sulphate and chondroitin-4-sulphate, but not with heparan sulphate. Heparan and dermatan sulphates affect haemostasis when added to whole blood in vitro, detectable by native thrombelastography and completely reversed by heparinase-I-modified thrombelastography. They may therefore be responsible for the heparin-like effect seen by thrombelastography in patients with cirrhosis and bacterial infection. © 2007 Lippincott Williams & Wilkins, Inc.