Increased Gal exposure is associated with enhanced clearance in a subset of patients with Low VWF. (A) Steady-state plasma VWF:Ag and VWFpp levels were determined by ELISA for control subjects and patients with low VWF, respectively. All ELISAs were performed in triplicate. Plasma VWFpp/VWF:Ag ratios were significantly elevated in patients with low VWF (△) compared with healthy controls (○). Mean values for each group are indicated by a black line; **P < .01. (B) For each control (○) and patient with low VWF (△), plasma VWF half-life was calculated using the VWFpp and VWF:Ag levels, as has been described.⁴⁹  The red dotted line designates a VWF:Ag half-life of 6 hours. (C) For the 28 low-VWF patients with plasma VWF:Ag half-life of less than 6 hours, a significant inverse correlation was observed between half-life and RCA-I binding (Gal exposure) to VWF (Spearman ranking = −0.47; P < .05).