Policlinico Gemelli IRCCS di Roma

Hemorrhagic & Thrombotic Disorders

The activity of the Hemorrhagic and Thrombotic Diseases Service (shortly known as SMET) concerns the diagnosis and therapy of coagulopathies and is aimed at patients with congenital and acquired haemorrhagic diseases, in particular:

  • haemophilia,
  • rare blood clotting defects,
  • von's disease Willebrand,
  • venous thrombosis (heart attack, stroke),
  • arterial thrombosis (heart attack, stroke),
  • thrombophilic states.

Genetic consultations and molecular genetic tests are also carried out to certify the status of a carrier of haemophilia.

In addition, monitoring of anticoagulant therapy (anti-vitamin K drugs and direct oral anticoagulants [DOACs]) are carried out.


Since July 2010 with the decree of the Lazio region 057/2010, SMET has also been accredited as an II-level center for haemophilia and congenital haemorrhagic diseases (MEC) and carries out diagnostic and therapeutic consultations to other departments and hospitals in the regional territory and extra-regional.

Assistance activity in Hemorrhagic & Thrombotic Disorders

Blood laboratory activities

The assistance activity is carried out through:

  1. Laboratory activities;
  2. Outpatient clinic activities.

Outpatient activities (screening of haemorrhagic coagulopathies, haemophilia, rare coagulopathies, classification of platelet disorders/platelet diseases, venous thrombosis, thrombotic microangiopathies, anticoagulant therapies) are closely interconnected and work in a network to deal with the problems of patients in a multidisciplinary manner.

Organization of the hemorrhagic and thrombotic diseases service

The laboratory staff is made up of:

  • 4 doctors,
  • 1 health manager,
  • 2 nurses,
  • 8 laboratory technicians,
  • 1 trainer,
  • 2 secretarial units.

The Service Laboratory is divided into the following sections:

  • Basic coagulation tests,
  • Second-level specialist blood coagulation tests.

The clinical activity of the Service is structured as follows: a clinic for the control of antithrombotic therapies, a clinic for congenital and acquired hemorrhagic and thrombotic diseases, and specialist sector consultancy for internal and external patients and for other hospitals.

Examinations carried out at the SMET Laboratories

  • Level I coagulation tests (e.g. PT, aPTT, fibrinogenemia, d-dimer, AT, etc.);
  • Level II coagulation tests (e.g. plasma coagulation factors, PC, PS, ADAMTS13 and related antibodies, multimeric VWF analysis, etc.);
  • Platelet function test in congenital and acquired thrombocytopenias/diseases;
  • Molecular genetic tests (FV Leiden, G20210A mutation of prothrombin, inversion of intron 22 of the FVIII gene);
  • Immunological tests for inhibitory antibodies (eg: anti-platelet antibodies, anti-heparin antibodies, anti-ADAMTS13 antibodies, etc.).

Outpatient Activities for Hemorrhagic & Thrombotic Disorders

Blood sampling

The SMET clinic is located on the first floor of wing C of the Polyclinic. It carries out a service (from Monday to Saturday) of blood sampling both in patients undergoing control of oral anticoagulant therapy and in patients who have to undergo diagnostic screening for coagulopathy.

Clinical activity on an outpatient basis is aimed at the nosographic classification of pathologies of the blood coagulation system with haemorrhagic and thrombotic characteristics and is carried out on Mondays, Tuesdays and Thursdays.

The outpatient activity also includes IV infusion of drugs and concentrates of coagulation factors for anti-haemorrhagic and diagnostic purposes.

Ready availability service

The ready availability service is carried out exclusively for the following services:

  • blood coagulation tests and consultations are provided for patients hospitalized for liver transplantation;
  • consultancy for patients with haemophilia and other congenital hemorrhagic coagulopathies.


Research is dedicated through various clinical studies and basic research to the study of genetic, etiopathogenetic bases, risk factors and optimization of medical therapy and complications of both hemorrhagic and thrombotic coagulopathies.


Blood classroom

UOSA provides teaching staff for the Master's Degree Course in Medicine and Surgery and Medicine & Surgery, as well as with the Specialty Schools of Internal Medicine, Clinical Pathology, Emergency Medicine and Urgency and Hematology of the Catholic University of S. Cuore, as well as with the Doctorate of Experimental and Translational Medicine.

Some structures belonging to the UOSA hold lessons within the Degree Course in Medicine and the Catholic Church of the Sacred Heart as well as tutoring activities.

Gemelli Rome Triangle


Gemelli Rome Triangle