Blood Coagulation and Beyond: Position Paper from the Fourth Maastricht Consensus Conference on Thrombosis

Akbulut A.C. Arisz R.A. Baaten C.C.F.M.J. Baidildinova G. Barakzie A. Bauersachs R. Ten Berg J. Van Den Broek W.W.A. De Boer H.C. Bonifay A. Bröker V. Buka R.J. Ten Cate H. Ten Cate-Hoek A.J. Cointe S. De Luca C. De Simone I. Diaz R.V. Dignat-George F. Freson K. Gazzaniga G. Van Gorp E.C.M. Habibi A. Henskens Y.M.C. Iding A.F.J. Khan A. Koenderink G.H. Konkoth A. Lacroix R. Lahiri T. Lam W. Lamerton R.E. Lorusso R. Luo Q. Maas C. McCarty O.J.T. Van Der Meijden P.E.J. Meijers J.C.M. Mohapatra A.K. Nevo N. Robles A.P. Poncelet P. Reinhardt C. Ruf W. Saraswat R. Schönichen C. Schutgens R. Simioni P. Spada S. Spronk H.M.H. Tazhibayeva K. Thachil J. Vallier L. Veninga A. Verhamme P. Visser C. Watson S.P. Wenzel P. Willems R.A.L. Willers A. Zhang P. Zifkos K. Van Zonneveld A.J.
24 July 2023 Georg Thieme Verlag

Thrombosis and Haemostasis
2023 #123 Issue 8 808 - 839 pp.

The Fourth Maastricht Consensus Conference on Thrombosis 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 infection-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: the value and limitations of ex vivo models. Perfusion flow chamber and nanotechnology developments are developed for studying bleeding and thrombosis tendencies. Vascularized organoids are utilized for disease modeling and drug development studies. Strategies for tackling extracorporeal membrane oxygenation-associated coagulopathy are discussed. Theme 5: Clinical dilemmas in thrombosis and antithrombotic management. Plenary presentations addressed controversial areas, i.e., 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.

antiplatelet agent , artificial surfaces , atherosclerosis , oral anticoagulants , thrombosis

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Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, Netherlands
Department of Hematology, Erasmus Mc, University Medical Center Rotterdam, Rotterdam, Netherlands
Institute for Molecular Cardiovascular Research (IMCAR), University Hospital Rwth Aachen, Aachen, Germany
Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz, Johannes Gutenberg-University Mainz, German Center for Cardiovascular Research (DZHK), Partner Site Rhein-Main, Mainz, Germany
Cardioangiologisches Centrum Bethanien - Ccb, Gefäß-Centrum, Frankfurt am Main, Germany
Department of Cardio-Thoracic Surgery, Maastricht University Medical Center, Maastricht, Netherlands
Department of Cardiology, St. Antonius Hospital, Nieuwegein, Netherlands
Department of Internal Medicine (Nephrology), The Einthoven Laboratory for Vascular and Regenerative Medicine, Leiden University Medical Center, Leiden, Netherlands
Aix-Marseille University, C2VN, Inserm 1263, Inrae 1260, Marseille, France
Department of Hematology and Vascular Biology, Chu la Timone, Aphm, Marseille, France
Institute of Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Vincent Drive, Birmingham, United Kingdom
Thrombosis Expertise Center, Maastricht University Medical Center, Maastricht, Netherlands
Laboratory of Morphology of Neuronal Networks and Systems Biology, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Napoli, Italy
Center for Molecular and Vascular Biology, Department of Cardiovascular Sciences, Ku Leuven, Leuven, Belgium
Department of Clinical-Surgical, Diagnostic and Pediatric Science, University of Pavia, Pavia, Italy
Department of Viroscience, Erasmus Medical Center, Rotterdam, Netherlands
Central Diagnostic Laboratory, Unit for Hemostasis and Transfusion, Maastricht University Medical Centre +, Maastricht, Netherlands
Mrc Weatherall Institute of Molecular Medicine, Radcliffe Department of Medicine, National Institute of Health Research (NIHR), Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
Department of Bionanoscience, Kavli Institute of Nanoscience Delft, Delft University of Technology, Delft, Netherlands
Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
Cdl Research, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR, United States
Department of Molecular Hematology, Sanquin Research, Amsterdam, Netherlands
Department of Experimental Vascular Medicine, Amsterdam Umc, University of Amsterdam, Amsterdam, Netherlands
Amsterdam Cardiovascular Sciences, Pulmonary Hypertension and Thrombosis, Amsterdam, Netherlands
Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
Department of Immunology, Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
R and T Department, BioCytex, Marseille, France
Center for Benign Haematology, Thrombosis and Haemostasis, Van Creveldkliniek, Umc Utrecht, University Utrecht, Utrecht, Netherlands
General Internal Medicine and Thrombotic and Hemorrhagic Diseases Unit, Department of Medicine, Padua University Hospital, University of Padua Medical School, Padua, Italy
Cancer Center of Shymkent, Al-Farabi Kazakh National University, Almaty, Kazakhstan
Department of Haematology, Manchester University Hospitals, Manchester, United Kingdom
Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
Leibniz Institute for Analytical Sciences - ISAS-e.V., Dortmund, Germany

Department of Biochemistry
Department of Hematology
Institute for Molecular Cardiovascular Research (IMCAR)
Center for Thrombosis and Hemostasis (CTH)
Cardioangiologisches Centrum Bethanien - Ccb
Department of Cardio-Thoracic Surgery
Department of Cardiology
Department of Internal Medicine (Nephrology)
Aix-Marseille University
Department of Hematology and Vascular Biology
Institute of Cardiovascular Sciences
Thrombosis Expertise Center
Laboratory of Morphology of Neuronal Networks and Systems Biology
Center for Molecular and Vascular Biology
Department of Clinical-Surgical
Department of Viroscience
Central Diagnostic Laboratory
Mrc Weatherall Institute of Molecular Medicine
Department of Bionanoscience
Wallace H. Coulter Department of Biomedical Engineering
Cdl Research
Department of Biomedical Engineering
Department of Molecular Hematology
Department of Experimental Vascular Medicine
Amsterdam Cardiovascular Sciences
Department of Immunology
Department of Immunology
R and T Department
Center for Benign Haematology
General Internal Medicine and Thrombotic and Hemorrhagic Diseases Unit
Cancer Center of Shymkent
Department of Haematology
Department of Cardiovascular Sciences
Leibniz Institute for Analytical Sciences - ISAS-e.V.

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