Fibrinolytic Activity in Plasma after Gynecological and Urological Surgery

Aranda, A.; Páramo, José A.; Rocha, Eduardo

doi:10.1159/000215794

Cited by 12 publications

(8 citation statements)

References 9 publications

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“…We previously reported similar results dur ing the postoperative period in patients un dergoing hip and abdominal surgery [11,21], and heart transplantation [22], emphasizing the possible role of PAI-1 in patients who develop postoperative thrombosis [23], Some authors also found high PAI-1 levels in patients undergoing extracorporeal circula tion [24,25], Further studies should be done to elucidate the role of the fibrinolytic shut down in the postoperative thrombotic com plications reported in these patients [26].…”

Section: Discussionmentioning

confidence: 62%

Intra- and Postoperative Fibrinolysis in Patients Undergoing Cardiopulmonary Bypass Surgery

Páramo

Rifón

Llorens

et al. 1991

Pathophysiol Haemos Thromb

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The influence of cardiopulmonary bypass (CPB) on fibrinolytic activity was assessed in 100 patients with valvular heart disease or atrial septal defects. Euglobulin fibrinolytic activity (EFA), tissue type plasminogen activator (t-PA) activity, plasminogen activator inhibitor 1 (PAI-1) activity, plasminogen, α₂-antiplasmin (α₂-AP), fibrinogen degradation products (FDP), and D-dimer were measured pre-, intra-, and postoperatively. There were significant increases in EFA and t-PA activity (p < 0.002), and decreases in plasminogen and α₂-AP (p < 0.0001) intraoperatively with respect to baseline values. t-PA activity decreased significantly after surgery (p < 0.002), whereas PAI-1 activity showed a marked increase shortly after operation and on postoperative day 1 (p < 0.0001). FDP and D-dimer levels were significantly increased both intra- and postoperatively, the latter showing higher values (p < 0.01 and p < 0.0001, respectively). This study shows that there is an activation of the fibrinolytic system, as a result of the increased activation of plasminogen and decreased levels of plasmin inhibitors, during CPB surgery followed by a postoperative fibrinolytic shutdown.

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Section: Discussionmentioning

confidence: 62%

Intra- and Postoperative Fibrinolysis in Patients Undergoing Cardiopulmonary Bypass Surgery

Páramo

Rifón

Llorens

et al. 1991

Pathophysiol Haemos Thromb

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“…Reduced fibrinolytic activity is a well-known feature of the early postoperative state and has been referred to as fibrinolytic shut-down [29][30][31]. A significant increase in FDP was also found postoperatively in both types of surgery, indicating fibrinolysis activation secondary to fibrin formation and plasmin generation, which was demonstrated by the PAP increase on days 3 and 7.…”

Section: Discussionmentioning

confidence: 99%

Hemostatic markers in surgery: a different fibrinolytic activity may be of pathophysiological significance in orthopedic versus abdominal surgery

López¹,

*²,

Pardo³

et al. 1998

International Journal of Clinical & Laboratory Research

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Without prophylaxis, patients subjected to major abdominal surgery have a risk of deep vein thrombosis of approximately 30%, while the rate varies between 40% and 60% in orthopedic surgery. The reasons for this discrepancy are not completely understood. The present study was designed to compare the pre-and postoperative behavior of different coagulation and fibrinolysis parameters in patients undergoing both types of surgery, receiving low molecular weight heparin prophylaxis. Samples were taken before operation and on postoperative days 1,3, and 7. The following parameters were assessed: prothrombin fragment 1+2, thrombin-antithrombin III complexes, fibrinopeptide A, tissue plasminogen activator, plasminogen activator inhibitor, plasmin-c~__-antiplasmin complexes, and fibrin degradation products. We found a significant increase in the clotting markers postoperatively compared with preoperative values (P<0.05), both in abdominal and orthopedic surgery, indicating a marked hemostatic activation which remained until postoperative day 7. A significant increase in plasminogen activator inhibitor (P<0.01) and a decrease in tissue plasminogen activator and plasmin-%-antiplasmin complexes was also observed early

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“…Further studies are needed to determine reproducibility and clinical signifi cance of this observation. In a more recent study [7], it was stated that no significant dif ferences were found between patients with and without malignancy, but no information was given about the actual comparisons made.…”

Section: Discussionmentioning

confidence: 99%

“…Surgery has been reported to induce rather stereotyped changes in the fibrinolytic sys tem, detectable as an intraoperative shorten ing and as a postoperative prolongation of the euglobulin lysis time [2,4,5,[7][8][9][10][11] and a post operative increase in PAI:Act with concomi tant decrease in tPA:Act in spite of unchanged or increased levels of tPA:Ag [7,9,[11][12][13][14][15]. 254 Rahr/Sarensen/I-arsen/Jensen/Bredahl Plasminogen Activators and Inhibitor in Surgery Similar changes were found in the present study.…”

Section: Discussionmentioning

confidence: 99%

Plasminogen Activators and Plasminogen Activator Inhibitor before and after Surgery in Patients with and without Gastric Malignancy

Rahr

Sørensen²,

Larsen³

et al. 1995

Pathophysiol Haemos Thromb

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Pre- and postoperative plasma levels of tissue-type plasminogen activator (t-PA), single-chain urinary plasminogen activator, and plasminogen activator inhibitor 1 (PAI-1) were measured in 40 patients undergoing gastric surgery in order to compare patients operated for benign (n = 21) and malignant (n = 19) disease. On the 1st postoperative day, the PAI-1 activity was significantly increased and the t-PA activity significantly decreased in the malignant group, whereas only insignificant changes were seen in the benign group. In contrast, the t-PA activity was significantly increased 1 week after surgery in patients without malignancy. In both groups, the single-chain urinary plasminogen activator activity decreased on the 1 st postoperative day, but was significantly increased 1 month after operation. Thus, the two groups reacted differently, but it remains to be determined whether this bears any relationship to the well-known high risk of postoperative venous thrombo-embolism in cancer patients.

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Fibrinolytic Activity in Plasma after Gynecological and Urological Surgery

Cited by 12 publications

References 9 publications

Intra- and Postoperative Fibrinolysis in Patients Undergoing Cardiopulmonary Bypass Surgery

Intra- and Postoperative Fibrinolysis in Patients Undergoing Cardiopulmonary Bypass Surgery

Hemostatic markers in surgery: a different fibrinolytic activity may be of pathophysiological significance in orthopedic versus abdominal surgery

Plasminogen Activators and Plasminogen Activator Inhibitor before and after Surgery in Patients with and without Gastric Malignancy

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