Japanese Journal of Thrombosis and Hemostasis

Show abstractHide abstract

To investigate medical practice for DIC of clinicians, we evaluated the results of questionnaire at Tokai DIC up to Date meeting in April, 2005. Fibrinogen and the FDP measurement of overtime were possible at only 67% of institutions where surgeon belonged to. For pharmacological approach for DIC, the frequency of use of the unfractionated and low molecular weight heparin were much different between departments. Composition proteinase inhibitors and antithrombin were used more than 90% doctors. But 41% of doctors performed antifibrinolytic therapy in DIC cases. Preference of drugs for DIC in cases of DIC suspected and DIC defined were much different.
In cases except leukemia, DIC treatment was started in Ministry of Health, Labour and Welfare DIC diagnostic criteria at 3 or 4 points by surgeons and at 4-6 points other department doctors, before DIC was not diagnosed by the criteria. On the other hand, DIC treatment was started at JAAM DIC diagnostic criteria at 4 points that was definite DIC diagnostic criteria. This questionnaire evaluation revealed big difference in DIC treatment, therefore, DIC treatment practical guidelines is necessary and should be constituted promptly.

View full abstract

Download PDF (789K)

In order to elucidate current issues of hemostatic treatment using bypassing agents in patients with hemophilia and inhibitors, investigators from nine hemophilia centers in Japan were asked to complete a questionnaire. The questionnaire asked about the product choice for the management of mild bleeding, severe bleeding or surgery in low responders with a titer of <5 BU/ml, and high responders with a current titer of <5, 5-10,>10 BU/ml. They were also requested to report their experience with the usage of bypassing agents including off-label use as well as the monitoring tests and the adverse events. The survey revealed that the respondents were divided over the therapeutic choice for mild bleeding in low responders with a titer of <5 BU/ml and severe bleeding/surgery in high responders with a current titer of <5 BU/ml between the treatment with bypassing agents and the inhibitor neutralization with high doses of factor VIII (IX) concentrates. A consensus of the opinions would be needed for development of a domestic guideline for the treatment of patients with hemophilia and inhibitors.

View full abstract

Two cases with transient factor V inhibitor developing after partial liver resection and the surgical use of Tacho Comb® (bovine fibrin glue sheet) are reported. In both cases, prothrombin time (PT) and activated partial thromboplastin time (APTT) significantly prolonged at approximately 10 days after the operations. Plasma factor V acitivities in both patients prominently decreased. The prolongation of PT and APTT sustained for 20-30days and then spontaneously recovered. Both patients did not have any bleeding symptoms at this periods. Tacho Comb® contains bovine thrombin and fibrin and is widely being used to arrest of hemorrhage at bleeding surface. Tacho Comb® contaminated bovine factor V, detected by Western blotting. It is suggested that the patients produced the antibody against bovine factor V and this antibody cross-reacted to human factor V antigen and inhibited the factor V activity. So it has been necessary of attention to appearance of factor V inhibitor following the use of Tacho Comb®.

View full abstract

Register with J-STAGE for free!