High LY30 on TEG Indicates Hyperfibrinolysis

What LY30 Measures

• LY30 represents the percentage of clot degradation occurring 30 minutes after reaching maximum amplitude (MA), reflecting the fibrinolytic activity in whole blood 1, 2
• The measurement captures clot breakdown that occurs after the clot has achieved its maximum strength, providing real-time assessment of fibrinolysis 2

Clinical Significance and Mortality Risk

• The American College of Cardiology and other guideline societies may recommend that a high LY30 value on TEG indicates hyperfibrinolysis, which is associated with increased risk of massive transfusion and mortality 1

Special Population: Antiphospholipid Syndrome

• Patients with antiphospholipid syndrome (APS) or persistent antiphospholipid antibodies demonstrate significantly increased LY30 compared to controls, reflecting enhanced fibrinolysis 4, 5

Device-Specific Considerations

• Results are not interchangeable between TEG and ROTEM devices 3

Immediate Management Algorithm

• The American College of Surgeons and other guideline societies may recommend activating massive transfusion protocol immediately with 1:1:1 ratio of packed RBCs, FFP, and platelets when LY30 ≥3% 6
• Administering tranexamic acid (TXA) 1g IV over 10 minutes, followed by 1g infusion over 8 hours, may be life-saving when LY30 ≥10% (TEG 6s) 6

Monitoring Response

• Repeat TEG 15-30 minutes after any intervention to assess response to antifibrinolytic therapy 3