SummaryFactor XIII (FSF or fibrinoligase), an enzyme required for normal blood coagulation, can be measured by its catalysis of the incorporation of a fluorescent amine, monodansylcadaverine (N-(5-aminopentyl)-5-dimethylamino-l-naphthalene-sulfon-amide) into casein. The amine incorporation test was applied to fourteen patients who had major operations. Levels of factor XIII were measured before surgery and at intervals of two, four, and six days after operation. Plasma factor XIII showed a significant, linear decrease for each day after surgery. Patients having orthopedic surgery showed less pronounced changes than the remaining patients. Factor XIII also decreased after operation in patients with neoplastic disease, but the change was not different from that after general surgical procedures done in the absence of neoplasia. Platelet factor XIII levels were increased on the second day after operation, diminished on day four, and increased above pre-operative levels on the sixth day after surgery. Possible explanations of the observations are presented.

A patient undergoing treatment with cytotoxic chemotherapy for Hodgkin's disease developed graft versus host disease (GVHD) following a transfusion of packed red cells. This is the 28th reported patient with a malignancy who did not have a bone marrow transplant and developed GVHD after transfusion of normal blood or blood products. All patients had received cytotoxic chemotherapy prior to acquiring GVHD. The underlying malignancies included lymphoma, acute leukemia, neuroblastoma, rhabdomyosarcoma, and glioblastoma. Twenty-three of the 28 patients died of GVHD. The incidence of transfusion-related GVHD in this patient population is low but the illness is often fatal as treatment is largely ineffective. Transfusion-related GVHD can be prevented by irradiating all blood products with 1500 rad prior to administration.

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