PDF icon PDF herunterladen
Thromb Haemost 1979; 42(05): 1529-1535
DOI: 10.1055/s-0038-1657055
Original Article
Schattauer GmbH Stuttgart

Effects of Splenectomy on Blood Coagulation and Fibrinolysis in Patients with Liver Cirrhosis: Possible Role of the Spleen in Haemostasis

Isao Kamisasa
The 2nd Department of Surgery and Department of Central Clinical Laboratory, Tokyo University School of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
,
Koh Hidai
The 2nd Department of Surgery and Department of Central Clinical Laboratory, Tokyo University School of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
,
Mrrsuo Sugiura
The 2nd Department of Surgery and Department of Central Clinical Laboratory, Tokyo University School of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
,
Tatsuo Wada
The 2nd Department of Surgery and Department of Central Clinical Laboratory, Tokyo University School of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
,
Manabu Yamanaka
The 2nd Department of Surgery and Department of Central Clinical Laboratory, Tokyo University School of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Received 23. März 1979

Accepted 31. Oktober 1979

Publikationsdatum:
18. Februar 2019 (online)

 als PDF herunterladen  Lizenzen und Reprints
Preview

Summary

Blood coagulation and fibrinolysis before and after splenectomy was studied in 74 cases of liver cirrhosis. A hypocoagulable state was found before splenectomy, but the platelet count, and the levels of fibrinogen, plasminogen, ±2-macroglobulin and antithrombin III increased significantly after splenectomy (p < 0.05 to p < 0.001). A marked improvement was observed on the values of r (reaction time), k (clot formation time) and ma (maximal amplitude) of thrombelastograms (p < 0.05 to p < 0.001). The prothrombin time was reduced after the surgery, but not significantly (0.05 < p < 0.1). The levels of arantitrypsin remained almost unchanged, while serum fibrinogen-fibrin degradation products (FDP) showed a slight decrease postoperatively.

The immunohistologic study of the spleen excised from 7 cases with liver cirrhosis, with the use of the direct immunofluorescence technique, demonstrated the deposits of fibrin in the splenic cords in all cases. It was not recognized in the spleens of 4 cases without cirrhosis used as the control.

A further study of the spleen weight and plasma fibrinogen level showed that a significant inverse correlation exists between these two parameters (p < 0.01).

These findings suggest that localized intravascular coagulation (LIC) occurs in the enlarged spleen associated with liver cirrhosis.