29, 39
A ristocetin-based point-of-care channel is named after its reagent, not after the abnormality it detects; here it was detecting acquired platelet dysfunction. And short perioperative support did not produce clinically significant multimer loss, which qualifies the prevalence figures from longer runs.
Paired pre-support versus post-explantation values
Garaj M, Durila M, Vajter J, Solcova M, Marecek F, Hrachovinova I. Artif Organs 2021;46(5):899-907. DOI 10.1111/aor.14142
Multiple-electrode aggregometry alongside formal von Willebrand assays (antigen, ristocetin cofactor, collagen binding, multimer index), before support and after explantation
20 patients, lung transplantation, short-run support — not a general ECMO population
The ristocetin aggregometry channel fell from 104.7 plus or minus 44.2 to 39.6 plus or minus 24.6 (p under 0.0001), suggesting severe von Willebrand deficiency. The formal assays said the opposite: antigen ROSE 136.4 to 181.8 percent (p=0.0068), ristocetin cofactor 129.4 to 168.8 (p=0.0088), collagen binding 117.5 to 160.5 (p=0.01); ratios unchanged; multimer index fell only 98.4 to 94.8 percent, which the authors called not clinically significant. No significant correlation between the ristocetin channel and any laboratory von Willebrand test. The ADP channel also fell (71.4 to 45.7, p=0.0004).
20 patients undergoing lung transplantation with short-term perioperative ECMO