The impact of major surgery on blood coagulation factors and thrombin generation

We studied the blood coagulation system of 14 patients with metastatic malignancies before and after they had undergone major surgery. In addition to measuring a battery of coagulation factors, we assessed the function of the system with assays of whole blood thrombin generation. With the exceptions...

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Bibliographic Details
Published in:American journal of hematology 2007-09, Vol.82 (9), p.815-820
Main Authors: Horne, McDonald K., Merryman, Paula K., Cullinane, Ann M., Nghiem, Khanh, Alexander, H. Richard
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Blood Coagulation Factors - analysis
Blood Coagulation Factors - metabolism
Blood Coagulation Tests
Carcinoma - complications
Carcinoma - surgery
Case-Control Studies
Female
Hematologic and hematopoietic diseases
Hemostasis, Surgical
Humans
Male
Medical sciences
Middle Aged
Neoplasm Metastasis
Thrombin - biosynthesis
Time Factors
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Summary:We studied the blood coagulation system of 14 patients with metastatic malignancies before and after they had undergone major surgery. In addition to measuring a battery of coagulation factors, we assessed the function of the system with assays of whole blood thrombin generation. With the exceptions of factor VIII (fVIII), which increased, and fibrinogen and fIX, which did not change, the activities of all the pro‐ and anticoagulant proteins were significantly lower postoperatively. However, the thrombin generating capacity of the system was relatively preserved. Although the integral of thrombin activity over time was lower after surgery, the mean peak thrombin concentration was unchanged and the time to clot formation was shortened. Similar changes could be reproduced by lowering the concentrations of pro‐ and anticoagulant factors together in control blood samples. Therefore, simultaneous reductions in pro‐ and anticoagulant proteins postoperatively worked to maintain the functional integrity of the blood coagulation system. Am. J. Hematol., 2007. Published 2007 Wiley‐Liss, Inc.
ISSN:0361-8609
1096-8652
DOI:10.1002/ajh.20963