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Hemostasis and Thrombosis Center Core Laboratory

The Hemostasis and Thrombosis Center Core (HTC) Laboratory offers an extensive array of routine and specialized assays for the assessment of normal hemostatic pathways. Services also include research protocol development and experimental study design, as well as data management and sample banking.

Dr Thomas Ortel is the Medical Director for the HTC Core Laboratory. He is Board-certified in Hematology and is the director of the Duke Clinical Coagulation and Platelet Antibody Laboratories.

Specialities

Hemostasis Testing – includes coagulation screening assays as well as testing for individual coagulation factors, factor inhibitors, and von Willebrand factor analysis.
Platelet Studies – includes screening assays for platelet function, platelet aggregometry, flow cytometric and ELISA analyses for anti-platelet antibodies, drug-induced anti-platelet antibodies, and flow cytometric analysis of platelet activation.
Thrombosis Testing – includes testing for natural anticoagulants, fibrinolytic proteins, testing for lupus anticoagulants, anticardiolipin antibodies, and anti-b₂glycoprotein I antibodies, homocysteine levels, and molecular diagnostics for factor V and prothrombin.
Hemostasis testing in animal model systems (e.g. murine, rat and baboon).
Pediatric testing – adaptation of assays to minimize blood volumes.
Test development – expertise in development of novel analytic strategies for evaluating and monitoring hemostatic mechanisms, including assessment of novel antithrombotic therapies, hemostatic agents, etc.

Examples of recently completed studies and trials

Primary Hemostasis Screening Study: Assessment of primary hemostasis in 305 patients recruited from 11 clinical settings at Duke.
Prospective Evaluation of Postoperative Inhibitors (PEPCI): Identification of acquired coagulation factor inhibitors in 151 patients after cardiac bypass surgery.
Point-of-Care Hemostasis Testing in Antiphospholipid Syndrome: Point-of-care and plasma testing for prothrombin times in 108 patients on chronic oral anticoagulation.
Preoperative Anti-Heparin/PF4 Antibodies and Adverse Outcomes with Cardiac Surgery: Antibody detection in 466 patients recruited at 2 medical centers.
Pharmacokinetic Analysis of Low Molecular Weight Heparin in Renal Failure: Pharmacokinetic analysis of the LMWH dalteparin in hemodialysis-dependent patients.
Clinical Evaluation of Waveform Abnormalities of the aPTT in Critically Ill Hospitalized Patients (the WATTCH Study): Waveform profiles detected in routine coagulation assays by photo-optical coagulometer analysis in 200 patients at risk for disseminated intravascular coagulation recruited at three sites.
Internet-based Expert System and Home INR Monitoring for Remote Management of Anticoagulant Therapy: Sixty patients on chronic warfarin therapy managed with an internet based expert system (CoagCare^®). (Study used for FDA application by ZyCare, Inc.)
Antiphospholipid Sydnrome Collaborative Registry (APSCORE) – The HTC Core Laboratory is performing lupus anticoagulant testing for this registry, which currently includes 800 patients recruited from 8 sites.
ENDOVASC Study – Hemostatic activation markers including tissue factor procoagulant activity, determined for 200 patients undergoing cardiopulmonary bypass recruited at 1 site.

Other ongoing study invovlement

Heparin-induced Thrombocytopenia (HIT) after Cardopulmonary Bypass Surgery - 800 patients at 4 sites will be recruited to determine the clinical significance of anti-heparin/platelet factor 4 antibodies developing in patients undergoing cardiopulmonary bypass surgery.
Animal Model of Hemolysis and Disseminated Thrombosis – Hemostatic markers determined in rats treated with 2-butoxyethanol.

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