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Cellular and Molecular Bioengineering

Cellular and Molecular Bioengineering - Poster Session E

T30 - Detecting Blood Thrombin-Related Markers in ECMO Patient Plasma Using an Antibody-Based ELISA

Saturday, October 11, 2025

10:00 AM - 11:00 AM PDT

Location: Exhibit Hall F, G & H

Presenting Author(s)

AM

Aditya Malhotra

Undergraduate Student
University of California, Los Angeles
Lake Oswego, Oregon, United States

Co-Author(s)

JS

Joseph J. Shatzel, M.D.

Associate Professor
Oregon Health & Science University, United States

Last Author(s)

JW

Jenny Si Han Wang

Postdoctoral Research Fellow
Oregon Health & Science University, United States

Introduction: : Thrombosis remains a common and serious complication of extracorporeal membrane oxygenation (ECMO), contributing substantially to patient morbidity and mortality. Current anticoagulation strategies are nonspecific and often carry a high risk of bleeding. To improve thrombotic risk assessment, there is a critical need for specific biomarkers that can detect thrombin-mediated clot formation, enabling more precise monitoring and targeted intervention.

Materials and

Methods: : Thrombin-antithrombin (TAT) and Factor XI-antithrombin (FXI-AT) complexes are generated during thrombin formation and contact pathway activation and may be elevated in the procoagulant environment of ECMO support. We developed a novel enzyme-linked immunosorbent assay (ELISA) using a monoclonal antibody engineered to selectively detect TAT and FXI-AT complexes. This assay was applied to analyze blood samples collected 24 hours prior to ECMO decannulation, as well as thrombus material retrieved from ECMO circuits. In parallel, we employed a novel computed tomography (CT)-based imaging technique to quantify thrombus volume within ECMO oxygenators.

Results, Conclusions, and Discussions:: In the ECMO patient samples (N=20) we consistently detected thrombin-antithrombin (TAT) and Factor XI-antithrombin (FXI-AT) complexes in plasma, indicating activation of both thrombin generation and the contact pathway. The mean oxygenator clot volume identified on imaging was 13.24% (median 11.98%), with 60% of patients exhibiting clot coverage greater than 10%, and 35% exceeding 20%. A subset of patients (15%) demonstrated minimal thrombus burden ( < 1%). We observed increasing circulating TAT levels in patients with high ECMO thrombus volume, warranting further investigation in future studies to validate and quantify this relationship. These findings support the potential utility of engineered antibody-based assays for monitoring thrombin formation in ECMO patients.

Acknowledgements and/or References (Optional): :