Download PDF
Thromb Haemost 1983; 49(02): 128-131
DOI: 10.1055/s-0038-1657337
Original Article
Schattauer GmbH Stuttgart

Antithrombin III Infusion in Patients Undergoing Peritoneovenous Shunt Operation: Failure in the Prevention of Disseminated Intravascular Coagulation

Harry Roger Büller
The University Hospital “Wilhelmina Gasthuis”, Department of Hematology, Division of Hemostasis, Amsterdam, The Netherlands
,
Jan W ten Cate
The University Hospital “Wilhelmina Gasthuis”, Department of Hematology, Division of Hemostasis, Amsterdam, The Netherlands
› Author Affiliations
Further Information

Publication History

Received 21 October 1982

Accepted 10 February 1983

Publication Date:
18 July 2018 (online)

  PDF Download  Permissions and Reprints

Summary

Five patients with chronic liver disease and acquired antithrombin III (AT III) deficiency undergoing peritoneovenous (LeVeen) shunting for ascites, resistant to medical therapy, were studied prospectively for the development of disseminated intravascular coagulation (D.I.C.) after selective correction of the plasma AT III activity. This was accomplished by continuous infusion of purified human AT III concentrate beginning one day prior to surgery and continuing five to seven days post-operatively. This rigorous transfusion scheme of AT III concentrate could not prevent D.I.C. and bleeding.

Keywords

Antithrombin III concentrate - DIC - Le Veen Shunt - Liver cirrhosis
 

  • References

  • 1 Berkowitz HD, Mullen JL, Miller LD. et al. Improved renal function and inhibition of renin and aldosterone secretion following peritoneovenous (LeVeen) shunt. Surgery 1978; 84: 120-126
    PubMedGoogle Scholar
  • 2 Biggs R. Human blood coagulation, haemostasis and thrombosis. Oxford: Blackwell Scientific Publications; 1972
    Google Scholar
  • 3 Brand P, Jespersen J, Gregersen G. Post partum haemolytic-uraemic syndrome successfully treated with Antithrombin III. Br Med J 1980; 1: 449-450
    PubMedGoogle Scholar
  • 4 Büller HR, Weenink AH, Treffers PE, Kahlé LH, Otten HA, Ten CateJW. Severe antithrombin III deficiency in a patient with preeclampsia. Observations on the effect of human AT III concentrate transfusion. Scand J Haematol 1980; 25: 81
    PubMedGoogle Scholar
  • 5 Collen D, Rouvier J, Chamone DAF, Verstraete M. Turnover of radiolabelled plasminogen and prothrombin in cirrhosis of the liver. Eur J Clin Invest 1978; 8: 185-195
    CrossrefPubMedGoogle Scholar
  • 6 Fumarola D. Intravascular coagulation ascitic fluid infusion and endotoxin. Ann Int Med 1979; 91: 929
    PubMedGoogle Scholar
  • 7 Giles AR, Sauder D, Seaton TL, Johnston M, Hirsh J. Changes in the coagulation status of patients undergoing autotransfusion of concentrated ascitic fluid as treatment of refractory ascites. Blood 1977; 50: 577
    PubMedGoogle Scholar
  • 8 Godal HC, Abildgaard U. Gelation of soluble fibrin in plasma ethanol. Scand J Haematol 1966; 3: 342-350
    PubMedGoogle Scholar
  • 9 Harmon DC, Demirjian Z, Ellman L, Fisher JE. Disseminated intravascular coagulation with the peritoneovenous shunt. Ann Int Med 1979; 90: 774-776
    CrossrefPubMedGoogle Scholar
  • 10 Kahlé LH, Schipper HG, Jenkins CSP, Ten CateJW. An automated method for the determination of antithrombin III activity. Thromb Res 1978; 12: 1003-1014
    CrossrefPubMedGoogle Scholar
  • 11 Kahlé LH, Lamping RJ, Ten CateJW. An automated amidolytic method for determination of plasminogen activity. In: Proceedings Second Amstol symposium. Amsterdam: 1981. p. 102
    Google Scholar
  • 12 Kahlé LH, Lamping RJ, Ten CateJW. Evaluation of an automated amidolytic antiplasmin assay. Thromb Haemostas 1979; 42: 49 (Abstr.).
    PubMedGoogle Scholar
  • 13 Lerner RG, Nelson JC, Corines P. Intravascular coagulation complicating peritoneal-atrial shunts. Abstract. Blood 1975; 50: 274
    PubMedGoogle Scholar
  • 14 Lerner RG, Nelson JC, Corines P, del GuercioL R M. Disseminated intravascular coagulation, complication of LeVeen peritoneovenous shunts. JAMA 1978; 240: 2064-2066
    CrossrefPubMedGoogle Scholar
  • 15 LeVeen HH, Christoudias G, Moon JP, Luft R, Falk G, Grosberg S. Peritoneovenous shunting for ascites. Ann Surg 1974; 180: 580-591
    CrossrefPubMedGoogle Scholar
  • 16 LeVeen HH, Wapnick S, Grosberg S, Kinney MJ. Further experience with peritoneovenous shunt for ascites. Ann Surg 1976; 184: 574-581
    CrossrefPubMedGoogle Scholar
  • 17 Miletich JP, Majerus DW, Majerus PW. Patients with congenital factor V deficiency have decreased factor Xa binding sites on their platelets. J Clin Invest 1978; 62: 824-831
    CrossrefPubMedGoogle Scholar
  • 18 Mortenson RA, Lawton RL. Surgical treatment for intractable ascites. Am J Surg 1978; 116: 929-932
    PubMedGoogle Scholar
  • 19 Phillips LL, Rodgers JB. Procoagulant activity of ascitic fluid in hepatic cirrhosis: In vivo and in vitro. Surgery 1979; 86: 714-721
    PubMedGoogle Scholar
  • 20 Schipper HG, Ten CateJW. Antithrombin III transfusion in patients with liver cirrhosis. Br J Haematol 1982; 52: 25-33
    CrossrefPubMedGoogle Scholar
  • 21 Schipper HG, Kahlé LH, Jenkins CSP, Ten CateJW. Antithrombin III transfusion in disseminated intravascular coagulation. Lancet 1978; 1: 854-856
    PubMedGoogle Scholar
  • 22 Schwartz ML, Swaim WR, Vogel SB. Coagulopathy following peritoneovenous shunting. Surgery 1979; 85: 671-676
    PubMedGoogle Scholar
  • 23 Semeraro N, Fumarola D, Mertens F, Vermylen J. Evidence that endotoxins enhance the factor X activity of washed human platelets. Br J Haematol 1978; 38: 243-249
    CrossrefPubMedGoogle Scholar
  • 24 Tarao K, So K, Moroi T. et al. Detection of endotoxin in plasma and ascitic fluid of patients with cirrhosis: its clinical significance. Gastroenterology 1977; 73: 539-542
    PubMedGoogle Scholar
  • 25 Thomson J. Hereditary coagulation disorders, laboratory techniques. In: Thomson J. (ed). Blood coagulation and haemostasis. pp. 117-157 Edinburgh, New York, Churchill Livingstone: 1980
    Google Scholar
  • 26 Tytgat GN, Collen D, Verstraete M. Metabolism of fibrinogen in cirrhosis of the liver. J Clin Invest 1971; 50: 1690-1701
    CrossrefPubMedGoogle Scholar
  • 27 Van WijkEM, Kahlé LH, Ten CateJW. The determination of prothrombin using an automated amidolytic technique. Presented at XVII Congress of the international society of haematology, XV Congress of the international society of blood transfusion. Paris 1978; 2: 862
    PubMedGoogle Scholar
  • 28 Van WijkEM, Kahlé LH, Ten CateJW. Automated amidolytic technique for the determination of factor X and factor X antigen; application to patients. Clin Chem 1980; 1: 885-890
    PubMedGoogle Scholar