Figure 6. Thromboelastography (TEG) measurements of coagulation.

A&B) Example of TEG traces: in cell-bead treated BAL Group 1 (A) and empty bead control treated BAL Group 2 (B). Clotting parameters quantified (C-F): Thromboelastography of blood during treatment with either Cell bead treated BAL (solid symbols) or empty bead control treated BAL (open symbols); n = 3: results for each pig are shown as a change from the start of ischaemia (normalized and denoted as 0 on Y axis), demonstrate changes in R-time (C), K-time (D), angle (E) and maximum amplitude (MA) (F). BAL was added ~2.5h later. The four parameters describe the overall clotting reaction. The R-time (min) reflecting fibrin formation rate, is functionally dependent on clotting factors, notably fibrinogen; reported as the reaction time from placement in the cup to 2mm amplitude on the tracing, thus, the higher the number the longer it takes for formation of clot. In both groups initially the time taken for fibrin formation is increased during liver failure; as the BAL effects an improvement in Group 1, the time taken for fibrin to form is reduced; in contrast in Group 2 the time continues to increase (C). The K time, reflecting viscoelasticity, is the time taken from the R time to the point where the trace amplitude reaches 20mm, indicating intrinsic clotting factor activity, as well as fibrinogen and platelet function. Similar to the R time, the longer the time the less intrinsic clotting factor activity; pigs in Group 1 show a decrease in K time with continued treatment whereas those in Group 2 continue to increase (D). The alpha angle (angle of slope of r to k denotes rate of clot formation); in Group 1, pigs had an increased angle with BAL treatment, in Group 2 animals the angle decreased with time (E). MA is the maximum amplitude on the trace, reflecting the absolute strength of the clot; Group 1 pigs showed a stronger clot compared with Group 2 animals (F).