Acquired FV inhibitors: a needless iatrogenic complication of bovine thrombin exposure

Streiff, Michael B.; Ness, Paul M.

doi:10.1046/j.1537-2995.2002.00011.x

Cited by 184 publications

(192 citation statements)

References 77 publications

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“…18,19 Human thrombin has generally replaced bovine sources in these preparations, because in 126 cases since 1955, patients exposed to bovine thrombin have acquired thrombin antibodies. [20][21][22] In addition, Hino and coworkers 23 reported three cases of iatrogenic parvovirus B19 transmission associated with commercial sealants.…”

Section: Humphreys Et Al 1378mentioning

confidence: 99%

Renal Injury and the Application of Polysaccharide Hemospheres: A Laparoscopic Experimental Model

Humphreys

Lingeman

Terry

et al. 2008

Journal of Endourology

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Background and Purpose: Microporous polysaccharide hemospheres (MPH) are hemostatic beads engineered from purified plant starch. MPH accelerates the natural clotting cascade by concentrating clotting factors and proteins on their surface while absorbing aqueous and low molecular weight components from blood. The purpose of this study was to determine the efficacy of MPH in achieving hemostasis in the setting of laparoscopic renal injury. Materials and Methods:In four domestic pigs, 16 laparoscopic renal trocar injuries were created (8 each of 12 and 5 mm). A standard hand-assisted laparoscopic approach was used to each kidney so that two lesions per kidney were randomly created. MPH was applied to each treatment lesion with light pressure maintained for 60 seconds. Four of the 16 lesions, two each of 12 and 5 mm, were allowed to bleed as controls. Hemostasis was defined as no active bleeding or oozing. The animals were sacrificed at the conclusion of the procedure. Results: The mean time to hemostasis for the 12-mm MPH and control lesions was 196.2 Ϯ 53.3 and 372.0 Ϯ 225.6 seconds, while the average blood loss was 8.3 Ϯ 3.7 and 12.0 Ϯ 4.9 g, respectively. For the 5-mm MPH and control lesions, the average time to hemostasis was 100.2 Ϯ 24.8 and 247.0 Ϯ 134.4 seconds, while the average blood loss was 8.3 Ϯ 3.8 and 9.0 Ϯ 0.7 g, respectively. The median number of applications of the MPH for the 5-and 12-mm injuries was 1 and 2, respectively. Conclusions: MPH provided a rapid and effective means of hemostasis for laparoscopic renal parenchymal injuries in this model. Additional evaluation is warranted, however, before general application is advisable.

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Section: Humphreys Et Al 1378mentioning

confidence: 99%

Renal Injury and the Application of Polysaccharide Hemospheres: A Laparoscopic Experimental Model

Humphreys

Lingeman

Terry

et al. 2008

Journal of Endourology

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“…The pathogenic mechanism of AFVI due to DEM is unknown, but if coagulopathy is observed during treatment with DEM, it will be necessary to measure the factor V activity. No standard treatment for AFVI has been established, however, immunosuppressive agents such as steroids are highly effective [3,7,8]. There have been reports of patients with AFVI improving spontaneously without treatment [3,7,8] and treatment is not necessary for asymptomatic patients [9].…”

Section: Discussionmentioning

confidence: 99%

Acquired Factor V Inhibitor Developing after Treatment with Dabigatran Etexilate Methanesulfonate: A Case Report and Review of the Literature

Sekiguchi

Yoshikawa

Shimada

et al. 2014

Indian J Hematol Blood Transfus

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A 90-year-old man presented with subcutaneous ecchymoses. He had been under treatment with dabigatran etexilate methanesulfonate (DEM). Prolonged APTT and decreased PT was developed 2 months after the start of DEM, more prolonged 6 months later. DEM was discontinued, the coagulopathy did not improve. Factor V activity was decreased, along with appearance of coagulation factor V inhibitor (FVI). He did not have antiphospholipid syndrome or malignancy. He was diagnosed as having acquired FVI caused by DEM. Steroid pulse therapy was effective. There have been 74 reported cases of AFVI induced by drug treatment, but none after treatment with DEM.

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“…6,7 For those related to bovine thrombin, the inhibitor emerged after a mean of 8.3 days of exposure and persisted for a shorter time of 2.3 months. 8 Overall, 72% of patients with acquired factor V inhibitors suffered bleeding complications, with 17% of those being fatal. 8 For those with acquired factor V deficiency with a known cause like bovine thrombin-induced factor V inhibitor, bleeding was less common (33%) and was associated with better prognosis and lower fatality (6%).…”

Section: Factor V Deficiency: Causes Clinical Course Laboratory Finmentioning

confidence: 99%

“…8 Overall, 72% of patients with acquired factor V inhibitors suffered bleeding complications, with 17% of those being fatal. 8 For those with acquired factor V deficiency with a known cause like bovine thrombin-induced factor V inhibitor, bleeding was less common (33%) and was associated with better prognosis and lower fatality (6%). 8 The highest mortality was found in patients with autoimmune disorder (30%) or cancer (24%).…”

Section: Factor V Deficiency: Causes Clinical Course Laboratory Finmentioning

confidence: 99%

Acquired factor V inhibitor in a patient receiving venous-venous extracorporeal membrane oxygenation for Legionella pneumonia

Leung¹,

Ng²,

Sin³

et al. 2015

Hong Kong Med J

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Acquired FV inhibitors: a needless iatrogenic complication of bovine thrombin exposure

Cited by 184 publications

References 77 publications

Renal Injury and the Application of Polysaccharide Hemospheres: A Laparoscopic Experimental Model

Renal Injury and the Application of Polysaccharide Hemospheres: A Laparoscopic Experimental Model

Acquired Factor V Inhibitor Developing after Treatment with Dabigatran Etexilate Methanesulfonate: A Case Report and Review of the Literature

Acquired factor V inhibitor in a patient receiving venous-venous extracorporeal membrane oxygenation for Legionella pneumonia

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