Recombinant human ADAMTS13 and plasma transfusion limit resuscitation fluids and endothelial damage in a rat trauma transfusion model. Data are shown as boxplots with range. (A) Lactate levels over time. After trauma and shock (T = 1 hour), rats were randomized in Ringer’s lactate, Ringer’s lactate + rhADAMTS13, or plasma transfusion. (B) Amount of bleeding during shock. (C) Pressure-fixed transfusion or infusion (Tx) strategy was applied, resulting in differences in the amount of resuscitation fluids needed to reach a MAP of 60 mm Hg. (D-F) Before trauma (T = 0) and 6 hours post-trauma, samples were analyzed for different measures, including syndecan-1 (D), soluble vascular adhesion molecule-1 (E), and IL-6 (F). *P < .05, **P < .01, and ***P < .001 between groups; #P < .05 within groups.