Hydroxyl-ethyl starch and albumin are associated with a mild coagulopathy, possibly related to hemodilution of coagulation factors and by binding of calcium.[25, 26] Albumin causes smaller ex-vivo clot formation and less stable clots.[26, 27] Thus, it is plausible that high-dose albumin is a mild antithrombotic agent. This evidence concerns the gene ALB and blood coagulation disease.