Red blood cells have historically been viewed as innocent bystanders in the process of
blood coagulation and thrombin generation; however a century of clinical evidence linking
red blood cells to thrombosis suggests the contrary. In this brief review, the biochemical
evidence for red blood cell involvement in thrombin generation is evaluated. It is concluded
that in addition to platelets, red blood cells actively participate in thrombin generation. A sub-
fraction of red blood cells express phosphatidylserine on their surface and unlike platelets …