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Titolo:
Coagulopathy following major liver resection: The effect of rBPI(21) and the role of decreased synthesis of regulating proteins by the liver
Autore:
Meijer, C; Wiezer, MJ; Hack, CE; Boelens, PG; Wedel, NI; Meijer, S; Nijveldt, RJ; Muller, MGS; Wiggers, T; Zoetmulder, FAN; Rinkes, IHMB; Cuesta, MA; Gouma, DJ; van de Velde, CHJ; Tilanus, HW; Scotte, M; Thijs, LG; van Leeuwen, PAM;
Indirizzi:
Vrije Univ Amsterdam, Univ Hosp, Dept Surg, NL-1081 HV Amsterdam, Netherlands Vrije Univ Amsterdam Amsterdam Netherlands NL-1081 HV erdam, Netherlands Vrije Univ Amsterdam, Univ Hosp, Dept Internal Med, NL-1081 HV Amsterdam, Netherlands Vrije Univ Amsterdam Amsterdam Netherlands NL-1081 HV erdam, Netherlands Netherlands Red Cross, Blood Transfus Serv, Cent Lab, Dept Pathophysiol Plasma Prot, Amsterdam, Netherlands Netherlands Red Cross Amsterdam Netherlands rot, Amsterdam, Netherlands Xoma Corp, Dept Clin Res, Berkeley, CA 94710 USA Xoma Corp Berkeley CA USA 94710 rp, Dept Clin Res, Berkeley, CA 94710 USA Univ Rotterdam Hosp, Dr Daniel Den Hoed Canc Ctr, Dept Surg, Rotterdam, Netherlands Univ Rotterdam Hosp Rotterdam Netherlands Surg, Rotterdam, Netherlands Antoni Van Leeuwenhoek Hosp, Netherlands Canc Inst, Dept Surg, Amsterdam, Netherlands Antoni Van Leeuwenhoek Hosp Amsterdam Netherlands msterdam, Netherlands Univ Utrecht Hosp, Dept Surg, Utrecht, Netherlands Univ Utrecht Hosp Utrecht Netherlands , Dept Surg, Utrecht, Netherlands Univ Amsterdam, Acad Med Ctr, Dept Surg, NL-1105 AZ Amsterdam, NetherlandsUniv Amsterdam Amsterdam Netherlands NL-1105 AZ Z Amsterdam, Netherlands Univ Leiden Hosp, Dept Surg, NL-2300 RC Leiden, Netherlands Univ Leiden Hosp Leiden Netherlands NL-2300 RC 00 RC Leiden, Netherlands Univ Rouen, Hop Charles Nicolle, Dept Gen & Digest Surg, Rouen, France Univ Rouen Rouen France Nicolle, Dept Gen & Digest Surg, Rouen, France Univ Rotterdam Hosp, Dijzigt Ziekenhuis, Dept Surg, Rotterdam, NetherlandsUniv Rotterdam Hosp Rotterdam Netherlands Surg, Rotterdam, Netherlands
Titolo Testata:
SHOCK
fascicolo: 4, volume: 15, anno: 2001,
pagine: 261 - 271
SICI:
1073-2322(200104)15:4<261:CFMLRT>2.0.ZU;2-L
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACUTE-PHASE RESPONSE; DISSEMINATED INTRAVASCULAR COAGULATION; PERMEABILITY-INCREASING PROTEIN; TUMOR-NECROSIS-FACTOR; PLASMINOGEN-ACTIVATOR; INFLAMMATORY RESPONSE; HEPATIC-FAILURE; PLASMA-LEVELS; INTERLEUKIN-6; HEPATECTOMY;
Keywords:
partial hepatectomy; hepatic failure; endotoxin; hepatic synthesis; coagulation and fibrinolytic pathway; disseminated intravascular coagulation;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
37
Recensione:
Indirizzi per estratti:
Indirizzo: van Leeuwen, PAM Vrije Univ Amsterdam, Univ Hosp, Dept Surg, De Boelelaan 1117, NL-1081 HV Amsterdam, Netherlands Vrije Univ Amsterdam De Boelelaan 1117 Amsterdam Netherlands NL-1081 HV
Citazione:
C. Meijer et al., "Coagulopathy following major liver resection: The effect of rBPI(21) and the role of decreased synthesis of regulating proteins by the liver", SHOCK, 15(4), 2001, pp. 261-271

Abstract

This prospective study investigated the role of reduced hepatic synthesis of regulating proteins in coagulopathy after partial hepatectomy (PH) compared with major abdominal surgery (MAS) without involvement of the liver. Furthermore, we studied the effect of rBPI(21), an endotoxin-neutralizing agent, on coagulopathy after PH was studied. Compared with MAS, PH resulted insignificantly elevated levels of thrombin-antithrombin-lll and plasmin-alpha2-antiplasmin complexes. Levels of antithrombin-3, alpha2-antiplasmin, fibrinogen, plasminogen, alpha2-macroglobulin (alpha2-M), and C1-inhibitor remained lower following PH. Treatment with rBPI(21) led to significantly lower levels of tissue-type plasminogen activator (t-PA). Post-operative disseminated intravascular coagulation (DIC) was associated with significantly higher bilirubin and t-PA plasma levels and significantly lower levels of alpha2-M. This study indicates that PH induced hepatic failure results in decreased synthesis of hepatic regulating plasma proteins and subsequent activation of coagulation and fibrinolysis. Prevention of t-PA release by rBPI(21) may have important clinical implications. Decreased availability of alpha2-M may be a factor in post-operative DIG.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/09/20 alle ore 10:06:06