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Titolo:
CHANGES IN COAGULATION AND FIBRINOLYSIS IN THE POSTOPERATIVE PERIOD IMMEDIATELY AFTER KIDNEY-TRANSPLANTATION IN PATIENTS RECEIVING OKT3 OR CYCLOSPORINE-A AS INDUCTION THERAPY
Autore:
DEIRA J; ALBERCA I; LERMA JL; MARTIN B; TABERNERO JM;
Indirizzi:
UNIV HOSP,SERV NEFROL,PASEO SAN VICENTE S-N SALAMANCA 37007 SPAIN UNIV HOSP,SERV NEFROL SALAMANCA 37007 SPAIN UNIV HOSP,HEMATOL SERV SALAMANCA 37007 SPAIN
Titolo Testata:
American journal of kidney diseases
fascicolo: 4, volume: 32, anno: 1998,
pagine: 575 - 581
SICI:
0272-6386(1998)32:4<575:CICAFI>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
TUMOR-NECROSIS-FACTOR; MONOCLONAL-ANTIBODY; RENAL-TRANSPLANTATION; RECIPIENTS; THROMBOSES; RELEASE;
Keywords:
RENAL TRANSPLANTATION; THROMBOTIC RISK FACTORS; MONOCLONAL ANTIBODY OKT3; CYCLOSPORINE A; SURGICAL STRESS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
23
Recensione:
Indirizzi per estratti:
Citazione:
J. Deira et al., "CHANGES IN COAGULATION AND FIBRINOLYSIS IN THE POSTOPERATIVE PERIOD IMMEDIATELY AFTER KIDNEY-TRANSPLANTATION IN PATIENTS RECEIVING OKT3 OR CYCLOSPORINE-A AS INDUCTION THERAPY", American journal of kidney diseases, 32(4), 1998, pp. 575-581

Abstract

Different immunosuppressive agents, in particular OKT3, have been implicated as causative factors in the risk for renal thrombosis in the period immediately after kidney transplantation. Also, in different types of vascular surgery, a state similar to hypercoagulation has been reported. To assess the extent to which OKT3, cyclosporine A (CsA), andsurgery itself affect coagulation and fibrinolysis, a study was conducted of 20 patients divided into two groups: group A, 10 patients received OKT3 (first dose during the induction of anesthesia); and group B, 10 patients received CsA (first dose at least 2 hours before transplantation). Basal determinations and determinations at 2, 4, and 24 hours after the induction of anesthesia were made. No differences were found between the groups with respect to the clinical and usual coagulation parameters. The following were studied in both groups: (1) markersof coagulation activity (prekallikrein [PKK] levels and formation of thrombin-antithrombin complexes [TATc]), (2) inhibitors and suppressors of hemostasis (antithrombin III [AT-III] and protein C [PC] activity), (3) markers of fibrinolysis activation (levels of plasminogen [PLG]and of alpha(2)-antiplasmin [(alpha(2)-APL]), and (4) markers of endothelial damage (tissue plasminogen activator [TPA] and thrombomodulin [TMD]), In both groups, an important formation of TATc was observed early, together with a decrease in PKK levels and consumption of both AT-ill and PC, which reached their lowest levels at 24 hours. This points to an activation of coagulation through the intrinsic route and a secondary consumption of hemostasis inhibitors, both possibly caused by surgery. A consumption of PLG and alpha(2)-APL was also observed, reflecting stimulation of the fibrinolytic system and a physiological response to the activation of coagulation. A greater release of endothelial TPA was only observed in the patients receiving OKT3 (P < 0.0001), possibly signaling endothelial activation. It is concluded that surgical stress could be the major factor triggering the alterations seen in hemostasis and their possible consequences. (C) 1998 by the National Kidney Foundation, Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 09/04/20 alle ore 20:01:18