Haematology and transfusion: acquired coagulopathies
Project Leader: Dr Michael Desborough, Academic Clinical Fellow
Michael’s research is on acquired coagulopathies with a focus on liver cirrhosis and intensive care. This has involved a combination of research methodologies including systematic reviews, national audits, clinical trials and laboratory work.
The Intensive Care Study of Coagulopathy 2 (ISOC2) is an observational trial assessing the significance of a prolonged prothrombin time in critically-ill ICU patients. The team are performing a multiparameter assessment of haemostasis including viscoelastic tests, thrombin generation, and procoagulant/anticoagulant assays. This trial aims to define the coagulopathy in these patients and to determine whether present methods for assessing bleeding risk are adequate.
The national audit of blood-component use in patients with liver cirrhosis has focused on how clinicians assess bleeding risk for patients with liver cirrhosis and triggers that are used for transfusion of blood components.
Michael has performed systematic reviews on intravenous immunoglobulin-induced haemolysis and fresh frozen plasma (FFP) in cardiac surgery; and narrative reviews on transfusion strategy in trauma, appropriate use of FFP for bleeding patients, appropriate use of FFP for prophylaxis, cytomegalovirus (CMV)-negative blood products, ethics of transfusion, and interpretation of simple tests of haemostasis. Lastly, he has had the opportunity to gain laboratory experience in simple tests of coagulation, viscoelastic tests, factor assays, inhibitor assays and enzyme-linked immunosorbent assays (ELISA).