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KMID : 0371319920420050575
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Journal of the Korean Surgical Society
1992 Volume.42 No. 5 p.575 ~ p.596
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An Experimental Study on the Changes of the Fibrinolytic System during Orthotopic Liver Tronsplantation in a Canine Model
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최동욱
이홍복/계경채/박선양/정중기/서경석/박규주/김상준/김수태
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Abstract
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Orthotopic liver transplantation is frequently associated with hemoststic disturbance and bleeding diathesis developing during the anhepatic phase of the operative procedure, Although the hemostatic defect has been attributed in part to
accelerated
fibrinolysis, the underlying pathophysiology has not been clarified. In order to testify the hypothesis that imbalance of tissue-type plasminogen activator(t-PA) and plasminogen activator inhibitor(PAI) might cause the fibrinolytic activation, we
evaluated the changes in fibrinolytic activity and specific blood fibrinolytic parameters, including t-PA and PAI during the surgery in 12 cases of canine OLT.
Increase in PA activity and t-PA antigen level was observed during the anhepctic phase. But PAI activity were not changed significantly, while PAI-1 concentration showed a tendency to decrease during surgery. We also confirmed the increased
activity of
t-PA during the anhepatic phase through a t-PA antibody neutralization test on fibrin autography after the SDS-PAGE. Decreased fibrinogen concentration was associated with increased PA activity during the anhepatic phase.
This result confirms the hypothesis that the fibrinolytic activation during anhepatic phase in OLT is associated with the imbalance in PA-PAI regulation. It appeared that increased t-PA activity resulted from both excessive intravascular release
from
endothelial cell and decreased hepatic clearance of t-PA.
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KEYWORD
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