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Item The resistance of swine blood clots to alteplase-induced thrombolysis in vitro is concentration-dependent(Elsevier, 2021) Neto-Neves, Evandro M.; Beam, Daren M.; Kline, Jeffrey A.; Emergency Medicine, School of MedicineBackground: Swine have been used as a large animal translational research model to investigate the effectiveness of fibrinolytic agents. However, swine thrombi have different characteristics than human thrombi, which may confer more resistance to fibrinolysis. Methods: In this study, we performed an in-vitro clot lysis assay to compare both human and swine blood clots lysis induced by alteplase, a recombinant tissue plasminogen-activator agent. Human and swine whole blood were allowed to clot for 3 h at 37 °C. Increasing concentrations of alteplase (250–580,000 IU/mL) or phosphate-buffered saline (PBS, pH 7.4) were added into the clots. Clot lysis was determined by calculating the difference between the clot mass pre- and post-lysis. Results: At low alteplase concentrations (250–2000 IU/mL) we observed significantly less swine blood clot lysis (14 ± 1.7% - 35 ± 4.9%) compared to the lysis found to human blood clots (52 ± 4.8% - 68 ± 3.3%, ∗p < 0.05). In contrast, we did not find lysis differences between human and swine clots at higher alteplase concentrations (5000–580,000 IU/mL). Conclusions: In conclusion, our results suggest that the swine clot resistance to alteplase-induced thrombolysis is concentration-dependent. A high concentration of alteplase allows equivalent thrombolysis of swine and human blood clots in vitro.