Blood coagulation and beyond: Position paper from the Fourth Maastricht Consensus Conference on Thrombosis

Cengiz Akbalut, Ryanne Arisz, Constance Baaten, Gaukhar Baildildinova, Aarazo Barakzie, Rupert Bauersachs, Jurriën M Ten Berg, Wout van den Broek, Hetty C de Boer, Vanessa Broker, Richard Buka, Hugo Ten Cate*, Arina Ten Cate, Ciro De Luca, Ilaria De Simone, Françoise Dignat-George, Kathleen Freson, Giulia Gazzaniga, Eric van Gorp, Anxhela HabibiYvonne M C Henskens, Aaron F J Iding, Abdullah Khan, Gijsje Koenderink, Akhil Konkoth, Romaric Lacroix, Trisha Lahiri, Wilbur Lam, Rachel Lamerton, Roberto Lorusso, Qi Luo, Coen Maas, Owen J T McCarty, Paola van der Meijden, Joost Meijers, Adarsh Mohapatra, Neta Nevo, Alejandro Pallares Robles, Philippe Poncelet, Christoph Reinhardt, Wolfram Ruf, Ronald Saraswat, Claudia Schonichen, Roger E G Schutgens, Paolo Simioni, Stefano Spada, Henri M H Spronk, Karlygash Tazhibayeva, Jecko Thachil, Rocio Vacik-Diaz, Alicia Veninga, Peter Verhamme, Chantal Visser, Steve P Watson, Philip Wenzel, Ruth Willems, Anne Willers, Pengyu Zhang, Konstantinos Zifkos, Anton-Jan van Zonneveld

*Corresponding author for this work

Research output: Contribution to journalEditorialAcademicpeer-review

Abstract

The 4th Maastricht Consensus Conference on Thrombosis (MCCT), included the following themes: Theme 1: The "coagulome" as a critical driver of cardiovascular disease Blood coagulation proteins also play divergent roles in biology and pathophysiology, related to specific organs, including brain, heart, bone marrow and kidney. Four investigators shared their views on these organ-specific topics. Theme 2: Novel mechanisms of thrombosis Mechanisms linking factor XII to fibrin, including their structural and physical properties, contribute to thrombosis, which is also affected by variation in microbiome status. Virus infections associated-coagulopathies perturb the hemostatic balance resulting in thrombosis and/or bleeding. Theme 3: How to limit bleeding risks: insights from translational studies This theme included state of the art methodology for exploring the contribution of genetic determinants of a bleeding diathesis; determination of polymorphisms in genes that control the rate of metabolism by the liver of P2Y12 inhibitors, to improve safety of antithrombotic therapy. Novel reversal agents for direct oral anticoagulants are discussed. Theme 4: Hemostasis in extracorporeal systems: how to utilize ex vivo models? Perfusion flow chamber and nanotechnology developments are developed for studying bleeding and thrombosis tendencies. Vascularised organoids are utilized for disease modeling and drug development studies. Strategies for tackling extracorporeal membrane oxygenation (ECMO) associated coagulopathy are discussed. Theme 5: Clinical dilemmas in thrombosis and antithrombotic management Plenary presentations addressed controversial areas, ie thrombophilia testing, thrombosis risk assessment in hemophilia, novel antiplatelet strategies and clinically tested factor XI(a) inhibitors,both possibly with reduced bleeding risk. Finally, Covid-19 associated coagulopathy is revisited.

Original languageEnglish
Pages (from-to)808-839
Number of pages32
JournalThrombosis and Haemostasis
Volume123
Issue number8
Early online date13 Mar 2023
DOIs
Publication statusPublished - 12 May 2023

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