Medcalf Group - Molecular Neurotrauma, Haemostasis
Key terms: Fibrinolysis, stroke, traumatic brain injury (TBI)

2023 group L-R: Back row - Georgia Fitzpatrick, Rob Medcalf, Zikou Liu. Front row - Isabel Tippett, Orr Zaacs, Heidi Ho, Fiona McCutcheon, Fei Wu, Charithani Keragala Wu. Absent - Joanne Chia, Suhani Sharma.
Group Leader
Awards
International Society on Thrombosis and Haemostasis (ISTH) Awards
- Prof Robert Medcalf won the 2025 ISTH Outstanding Mentor Award
- Prof Robert Medcalf won the 2024 ISTH Esteemed Career Award.
- Dr Charithani Keragala won the 2024 ISTH Training Fellowship
Stroke Society of Australia (SSA) Award
- Prof Robert Medcalf won the 2023 SSA Excellence in Stroke Award.
Cardiovascular Science Award
- Prof Robert Medcalf won the Heart Lung and Circulation 2023 Cardiovascular Science Award.
Eberhard Mammen Young investigator award
- Dr Charithani Keragala won the 2023 Eberhard Mammen Young investigator award
Dean's Awards for Excellence in Research and Supervision
- Prof Robert Medcalf won the 2019 Dean's Award for Excellence in Research (Postgraduate Research Supervision).
- Prof Robert Medcalf won the 2020 Dean's Award for Excellence in Education - Honours Supervision.
YouTube video presentation (3:28 min): Prof Robert Medcalf won the 2020 Dean's Award for Excellence in Education - Honours Supervision
Publications
- Medcalf publication accolade
- Editorial by Prof Medcalf on "Fibrinolysis and Trauma Outcomes" published in Anesthesiology, Jan 2022
Podcast
Selected publications since 2020
- Moore, H B., Gando, S; Iba, T; Kim, P.K., Yeh, C.H., Hunt, B., Levy, J.H., Draxler, D.F. Stanworth, S., Gorlinger, K., Neal, M.D., Schreiber, M., Barrett, C.D., Medcalf, R.L., Moore, E.E., Mutch, N.J., Thachil, J., Urano, T., Thomas, S., Scărlătescu, E., Walsh, M. (2020). Defining the coagulopathy of trauma with respect to implications for patient therapy: communication from the SSC of the ISTH. J Thromb Haemost 18:740-747. doi: 10.1111/jth.14690.
- Medcalf, R.L., Keragala, C.B., and Myles, P.S. (2020) Fibrinolysis and COVID-19: A plasmin paradox. J Thromb Haemost. Sep;18(9):2118-2122. doi: 10.1111/jth.14960.
- Daglas, M, Galle, A., Draxler, D.F., Sashindranath, M., and Medcalf, R.L. (2020). Sex-dependent effects of tranexamic acid on blood-brain barrier permeability and the immune response following traumatic brain injury in mice. J Thromb Haemost Oct;18(10):2658-2671. doi: 10.1111/jth.15015.
- Keragala, C.B., Woodruff, T., Liu, Z., Niego, B., Ho, H., McQuilten. Z., and Medcalf, R.L. (2020). Tissue-type plasminogen activator and tenecteplase-mediated increase in blood-brain barrier permeability involves cell intrinsic complement. Frontiers in Neurology. Dec 8;11:577272. doi: 10.3389/fneur.2020.577272. eCollection 2020.
- Draxler, D.F. Zahra, S., Concalves, I., Hanafi, G., Ho, H., Keragala, C.B., Illich, A., Key, N., Myles, P.S., Medcalf, R.L. (2020) Tranexamic acid inhibits fibrinolysis, yet transiently enhances plasmin generation in vivo. Blood, Coagulation and Fibrinolysis. 32(3): 172-179. doi: 10.1097/MBC.0000000000001008.
- Keragala, C.B., and Medcalf, R.L. (2021). Plasminogen: an enigmatic zymogen. Blood 137(21):2881-2889. Doi: 10.1182/blood.2020008951.
- Mutimer, C., Keragala, C. B., Markus, H.S., Werring, D.J., Cloud, G.C., and Medcalf, R.L. (2021) Cerebral amyloid angiopathy and the fibrinolytic system: is plasmin a therapeutic target? Stroke 52(8):2707-2714. doi: 10.1161/STROKEAHA.120.033107.
- Palazzolo, J.S., Karen Alt, K., Ale, A., Broughton, B.R.S., Ho, H., Medcalf, R.L., Wright, D.K., Jagdale, S., Hagemeyer, C.E., and Niego, B. (2022). Platelet-targeted thrombolysis for treatment of acute ischemic stroke. Blood Advances. Apr 28:bloodadvances.2021006691. doi: 10.1182/bloodadvances.2021006691.
- Palazzolo, Medcalf, R.L., Hagemeyer, C.E., and Niego, B. (2022). A Novel Ex Vivo Approach for Measuring Plasminogen Activation Upon Established Plasma Clots. Res Pract Thromb Haemost. 2022 Jul 21;6(5):10.1002/rth2.12771. doi: 10.1002/rth2.12771. eCollection 2022 Jul
- Smart, C., Mitchell, A., McCutcheon, F., Medcalf, R.L, Thiele, A. (2023). Tissue-type plasminogen activator induces conditioned receptive field plasticity in the mouse auditory cortex. iScience. 26(2):105947 doi: 10.1016/j.isci.2023.105947.
- Coupland, L.A., Rabbolini, D., Crispin, P.J., Schoenecker, J.G., Miller, J.J., Ghent, T., Medcalf, R.L., Aneman, E.A. (2023). Point-of-care Diagnosis and Monitoring of Fibrinolysis Resistance in the Critically Ill: Results from a Feasibility Study. Crit Care 27(1):55. doi: 10.1186/s13054-023-04329-5.
- Gruen, R.L. Mitra, B., Bernard. S., McArthur, C., Burns, B., Gantner, D., Maegele, M., Cameron, P.A., Dicker, B., Forbes, A., Hurford. S., Martin, C.A., Mazur, S.M., Medcalf, R.L., Murray, L., Myles, P.S., Ng, S.J., Pitt, V., Rashford, S., Reade, M.C., Swain, A.H., Trapani, T., Young, P.J. (The PATCH-Trauma Study Investigators). (2023) Pre-hospital Tranexamic Acid for Severe Trauma. New Engl J Med Jul 13;389(2):127-136. doi: 10.1056/NEJMoa2215457. Epub 2023 Jun 14.
- Liu, Z., McCutcheon, F.M., Ho, H., Chia. J., Xiao, Y., Tippett, I., Keragala,C.B., Cloud, G.C., Medcalf, R.L. (2023). Tranexamic acid in a mouse model of cerebral amyloid angiopathy: setting the stage for a novel stroke treatment. Res Pract Thromb Haemost Aug 9;7(6):102166. doi: 10.1016/j.rpth.2023.102166. eCollection 2023.
- Mutch N.J., and Medcalf R.L. (2023). The fibrinolysis Renaissance. J Thromb Haemost Dec;21(12):3304-3316. doi: 10.1016/j.jtha.2023.09.012.
- McQuilten, Z.K., Wood, E.M., and Medcalf, R.L. (2023). When to use tranexamic acid for the treatment of major bleeding? J. Thromb. Haemost 10:S1538-7836(23)00735-3. doi.org/10.1016/j.jtha.2023.10.001
- Lam, T., Medcalf, R.L., Cloud, G.C., Myles, P.S., Keragala, C.B. (2023) Tranexamic acid for haemostasis and beyond: Does dose matter? Thrombosis J Sep 12;21(1):94. doi.org/10.1186/s12959-023-00540-0.
- Keragala, C.B**., McFadyen, J.D**., Ho, H., McCutcheon, F.M., Liu, Z., Stevens, H., Monagle, P., Chunilal, S., Medcalf, R.L*., Tran, H*. (2024). Plasma from patients with Vaccine-induced immune thrombotic thrombocytopenia displays increased fibrinolytic potential and enhances tPA but not uPA-mediated plasminogen activation. J Thromb Haemost 2024 Mar;22(3):785-793 doi: 10.1016/j.jtha.2023.10.027. *co-senior authors. **co-first authors.
- Yogendrakumar, V., Vandelanotte, S., Mistry, E.A., Hill, M.D., Coutts, S.B., Nogueira, R.G., Nguyen, T.N., Medcalf, R.L., Broderick, J.P., De Meyer, S.F., Campbell, B.C.V. (2024). Emerging Adjuvant Thrombolytic Therapies for Acute Ischemic Stroke Reperfusion. Stroke. Oct;55(10):2536-2546. doi: 10.1161/STROKEAHA.124.045755
- Barrett, C.D., Neal, M.D., Schoenecker, J.D., Medcalf, R.L., Myles, P.S. (2024) Tranexamic acid in trauma: After 3 hours from injury, when is it safe and effective to use again? Transfusion May;64 Suppl 2:S11-S13. doi: 10.1111/trf.17779
- Yogendrakumar, Y., Lin, L., Medcalf, R.L., Parsons, M (2024). Improving thrombolysis efficiency for acute ischaemic stroke. Lancet Neurol 23 (9), 853-855 (Invited commentary). Doi:10.1016/S1474-4422(24)00318-1.
- Gruen, R.L. Mitra, B., Bernard. S., et al, MEDCALF, R.L., Murray, L., Myles, P.S., Ng, S.J., Pitt, V., et al Trapani, T., Young, P.J. (The PATCH-Trauma Study Investigators). (2023) Pre-hospital Tranexamic Acid for Severe Trauma. New Engl J Med Jul 13;389(2):127-136. doi: 10.1056/NEJMoa2215457. Epub 2023 Jun 14.
- Liu, Z., McCutcheon, F.M., Ho, H., Chia. J., Xiao, Y., Tippett, I., Keragala,C.B., Cloud, G.C., MEDCALF, R.L (2023). Tranexamic acid in a mouse model of cerebral amyloid angiopathy: setting the stage for a novel stroke treatment. Res Pract Thromb Haemost Aug 9;7(6):102166. doi: 10.1016/j.rpth.2023.102166. eCollection 2023
- Lam, T., Medcalf, R.L., Cloud, G.C., Myles, P.S., Keragala, C.B. (2023) Tranexamic acid for haemostasis and beyond: Does dose matter? Thrombosis J 21, 94. https://doi.org/10.1186/s12959-023-00540-0.
- McQuilten, Z.K., Wood, E.M., and Medcalf, R.L. (2023). When to use tranexamic acid for the treatment of major bleeding? J. Thromb. Haemost 10:S1538-7836(23)00735-3. doi.org/10.1016/j.jtha.2023.10.001
- Mutch N.J., and MEDCALF, R.L. (2023). The fibrinolysis Renaissance. J Thromb Haemost (in press) 2023
- Lam, T., MEDCALF, R.L., Cloud, G.C., Myles, P.S., Keragala, C.B. (2023) Tranexamic acid for haemostasis and beyond: Does dose matter? Thrombosis J 21, 94. https://doi.org/10.1186/s12959-023-00540-0.
- McQuilten, Z.K., Venkatesh, B et al…, MEDCALF, R.L et al Tong, S.Y.C. (100 co-authors) (2022). Anticoagulation strategies in Non-Critically ill patients with COVID-19. NEJM Evidence. EVIDoa2200293. doi.org/10.1056/EVIDoa2200293.
- Coupland, L.A., Rabbolini, D., Crispin, P.J., Schoenecker, J.G., Miller, J.J., Ghent, T., Medcalf, R.L., Aneman, E.A. (2023). Point-of-care Diagnosis and Monitoring of Fibrinolysis Resistance in the Critically Ill: Results from a Feasibility Study. Critical Care 27:55 https://doi.org/10.1186/s13054-023-04329-5 .
- Mutimer, C., Keragala, C. B., Markus, H.S., Werring, D.J., Cloud, G.C., and Medcalf, R.L. (2021) Cerebral amyloid angiopathy and the fibrinolytic system: is plasmin a therapeutic target? Stroke 52(8):2707-2714. doi: 10.1161/STROKEAHA.120.033107
- Medcalf, R.L. Keragala, C.B., and Myles, P.S. (2020). Fibrinolysis and COVID-19: A plasmin paradox. J Thromb Haemost. Sep;18(9):2118-2122. doi: 10.1111/jth.14960
- Daglas, M, Galle, A., Draxler, D.F., Sashindranath, M., and Medcalf, R.L. (2020). Sex-dependent effects of tranexamic acid on blood-brain barrier permeability and the immune response following traumatic brain injury in mice. J Thromb Haemost Oct;18(10):2658-2671. doi: 10.1111/jth.15015.
- Draxler, D.F., Yep, K., Hanafi, G., Winton, A., Daglas, M., Ho, H., Sashindranath, M., Wutzlhofer, L.M., Forbes, A., Goncalves, I., Tran, H., Wallace, S., Plebanski, M., Myles, P.S., Medcalf, R.L. (2019). Tranexamic acid modulates the immune response and reduces post-surgical infection rates. Blood Advances, 28;3(10):1598-1609. doi: 10.1182/bloodadvances.2019000092.
- Daglas, M, Draxler, D.F., Ho, H., McCutcheon, F., Galle, A, Au, A-E, Larsson, P., Gregory, J., Alderuccio, F., Sashindranath, M, Medcalf, R.L. (2019). Activated CD8+ T cells cause long-term neurological dysfunction following traumatic brain injury. Cell Reports, Oct 29;29(5):1178-1191.e6. doi: 10.1016/j.celrep.2019.09.046
- Draxler, D.F., Lee, F., Ho, H., Keragala, C.B., Medcalf, R.L., Niego, B. (2019). t-PA suppresses the immune response and aggravates neurological deficit in a murine model of ischemic stroke. Frontiers Immunol. 10:591. doi: 10.3389/fimmu.2019.00591. eCollection 2019.

