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Training > Residency Program > Faculty Alphabetical > George Despotis, MD

Associate Professor, Pathology and Immunology
Associate Professor, Anesthesiology
BJH Service Building, 2nd Floor, Room 272
Office: (314) 362-6586
E-mail: despotisg@wustl.edu
Pub Med Search

Research

Initial studies were designed to validate point-of-care coagulation and platelet function instruments with respect to accuracy, reproducibility and ability to identify patients at risk for bleeding. Subsequent studies have examined the clinical utility of these methods. Point-of-care (POC) diagnostic systems, when incorporated into treatment algorithms, were shown to optimize the perioperative management (i.e., using either pharmacologic or transfusion-based therapies) of bleeding patients. Initial use of whole blood PT, aPTT and platelet count have been enhanced by incorporation of new, point-of-care platelet function tests.

After identifying factors that were associated with excessive bleeding and transfusion, several studies were performed to validate point-of-care methods with respect to monitoring of heparin anticoagulation/neutralization. Optimal management of anticoagulation/reversal (i.e., heparin and protamine dosing) led to reduced transfusion requirements and blood loss after cardiac surgery. Maintenance of patient-specific heparin concentrations during extracorporeal circulation resulted in preservation of coagulation factors (i.e., factors V, VIII, fibrinogen, AT III), platelets (i.e., using bleeding time) secondary to better suppression of thrombin (fibrinopeptide A) and fibrinolytic (D-dimers) activity. Point-of-care methods, as well as antithrombotic agents, also were used to optimize anticoagulation for ventricular assist devices in two recent reports. Several projects involving platelet donor safety, plasma apheresis and stem cell collection procedures have been pursued in the transfusion medicine environment. Other projects have focused on the use of novel (recombinant antithrombin III) agents to preserve hemostasis during extracorporeal circulation to minimize transfusion-related and thrombotic sequalae

Clinical Interest

Laboratory and Genomic Medicine - Blood Bank & Transfusion Medicine

Selected Publications

Despotis GJ, Levine V, Saleem R, Joist JH, Spitznagel E.. Desmopressin reduces blood loss and transfusion in cardiac surgical patients with impaired platelet function identified using a point-of-care test: A double blind, placebo controlled trial.. Lancet 354:106-110, 1999 Abstract

Despotis GJ, Goodnough LT, Dynis M, Baorto D, Spitznagel E.. Serious adverse events in normal platelet pheresis donors: A multivariate analysis in a hospital-based program.. Vox Sang 77:24-32, 1999 Abstract

Despotis GJ, Joist JH, Hogue CW Jr, Alsoufiev A, Joiner-Maier D, Santoro SA, Spitznagel E, Weitz JI,. More effective suppression of hemostatic system activation in patients undergoing cardiac surgery by heparin dosing based on heparin blood concentrations rather than ACT.. Thromb Haemost 76:902-908, 1996 Abstract

Despotis GJ, Joist JH, Hogue CW Jr, Alsoufiev A, Kater K, Goodnough LT, Santoro SA, Spitznagel E, Ro. The impact of heparin concentration and activated clotting time monitoring on blood conservation: a prospective, randomized evaluation in patients undergoing cardiac operations.. J Thorac Cardiovasc Surg 110:46-54, 1995 Abstract

Despotis GJ, Santoro SA, Kater KM, Spitznagel E, Cox JL, Barnes, Lappas DG.. Prospective evaluation and clinical utility of on-site coagulation monitoring in patients undergoing cardiac operation.. J Thorac Cardiovasc Surg 107:271-279, 1994 Abstract