Coagulopathy as a result of factor V inhibitor after exposure to bovine topical thrombin

We describe a case of severe coagulopathy after mesenteric revascularization. Laboratory investigation results revealed the presence of plasma inhibitors of factor V believed to result from exposure to bovine thrombin used for intraoperative hemostasis. Vascular and cardiothoracic surgeons commonly...

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Bibliographic Details
Published in:Journal of vascular surgery 2002-02, Vol.35 (2), p.400-402
Main Authors: Neschis, David G., Heyman, Meyer R., Cheanvechai, Vasana, Benjamin, Marshall E., Flinn, William R.
Format: Article
Language:English
Subjects:
Administration, Topical
Aged
Animals
Antibodies - immunology
Biological and medical sciences
Blood Coagulation Disorders - chemically induced
Cattle
Drug toxicity and drugs side effects treatment
Factor V - adverse effects
Factor V - antagonists & inhibitors
Factor V - immunology
Female
Humans
Medical sciences
Pharmacology. Drug treatments
Postoperative Complications - etiology
Thrombin - adverse effects
Thrombin - immunology
Toxicity: blood
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Summary:We describe a case of severe coagulopathy after mesenteric revascularization. Laboratory investigation results revealed the presence of plasma inhibitors of factor V believed to result from exposure to bovine thrombin used for intraoperative hemostasis. Vascular and cardiothoracic surgeons commonly use topical thrombin for surgical hemostasis, and many patients undergo multiple exposure. More patients likely have factor V inhibitors develop than has previously been realized, and this may account for some otherwise unexplained postoperative coagulation disorders. This report may alert surgeons to coagulation disturbances that can result from exposure to bovine thrombin and provide guidelines for diagnosis and management. (J Vasc Surg 2002;35:400-2.)
ISSN:0741-5214
1097-6809
DOI:10.1067/mva.2002.118587