Fibrinogen, Factor XIII And Antiplasmin In Hemostasis

Removal of large numbers of pulmonary metastases in cancer patients represents a serious problem since adequate hemostasis requires meticulous suturing and prolonged open chest procedures. For this reason, we tried to develop methods for obtaining rapid hemostasis. A double syringe system was constructed in which simultaneously we discharged from one syringe a mixture of highly concentrated human fibrinogen, platelet growth factor, antiplasmin, and Factor XIII (FS); from the second syringe we discharged thrombin and calcium chloride. After a few mm of passage through the common part of the nozzle, the mixture coated the area of pulmonary resection. In a series of experiments in dogs and stumptailed monkeys (Macaca arctoides) bleeding times of comparable pulmonary biopsies were recorded. FS alone or in association with suturing produced rapid hemostasis and as shown by follow-up histopathologic examination promoted healing without significant tissue reactions. This method proved to be superior in comparative experiments to the use of cryoprecipitate and thrombin or microfibrillar collagen preparations.

In a series of experiments, splenic injuries were induced in dogs, normally requiring splenectomy. The same three hemostatic methods described above were studied in this model. Adequate hemostasis was obtained with FS. This material appeared to be suitable to obviate the need of splenectomy and its hematologic consequences in traumatic rupture of the spleen.