Fibrinolytic activity in plasma after gynecological and urological surgery
Aranda A, Páramo JA, Rocha E.
Hematology Service, University Clinic, University of Navarra, Pamplona, Spain.
Fibrinolytic activity was studied in 51 patients subjected to major surgery (27 urological and 24 gynecological) without prophylaxis. Postoperative deep-vein thrombosis (DVT) was diagnosed by venography in 6 patients (11%).
Blood samples were obtained preoperatively and on days 1, 3 and 7 postoperatively. Reduced fibrinolytic activity, as determined by prolongation of euglobulin lysis time (ELT), decrease in plasminogen activators on fibrin plate and decrease in tissue-type plasminogen activator (t-PA) activity were present postoperatively. Moreover, a marked increase in short duration in fast-acting inhibitor (PA-inhibitor) levels was observed on postoperative day 1 (p less than 0.001). Patients with DVT had higher fibrinogen degradation product (FDP) levels on postoperative days 3 and 7 (p less than 0.02).
Preoperative PA-inhibitor activity was higher (p less than 0.02) in those patients who developed postoperative DVT. It is concluded that the decrease in t-PA and the increase in PA-inhibitor may contribute to the reduced postoperative fibrinolytic activity after major surgery. PA-inhibitor may represent a useful predictive marker of postoperative DVT.
CITATION Haemostasis. 1988;18(2):129-34