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KMID : 1188320180120040471
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Gut and Liver
2018 Volume.12 No. 4 p.471 ~ p.477
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Clinical Impact of Recombinant Soluble Thrombomodulin for Disseminated Intravascular Coagulation Associated with Severe Acute Cholangitis
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Okuda Atsushi
Ogura Takeshi
Imanishi Miyuki
Miyano Akira
Nishioka Nobu
Higuchi Kazuhide
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Abstract
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Background/Aims: Recently, recombinant human soluble thrombomodulin (rTM) has been developed as a new drug for disseminated intravascular coagulation (DIC). This study aims to evaluate the clinical benefit of rTM in patients with sepsis-induced DIC caused by acute cholangitis who underwent biliary drainage.
Methods: Patients were divided into two groups: the rTM therapy group and the non-rTM therapy group. The primary outcome was the DIC resolution rate at 7 days, and the secondary outcome was 28-day mortality rate.
Results: Thirty-five patients were treated by rTM, and 36 patients were treated without rTM for DIC. The rate of resolution of DIC at day 7 was significantly higher in the rTM group than in the non-rTM group (82.9% vs 55.6%, p=0.0012). Compared with the non-rTM group, the 28-day survival rate of the r-TM group was significantly higher (rTM vs non-rTM, 91.4% vs 69.4%, p=0.014). According to multivariate analysis, non-rTM (hazard ratio [HR], 2.681) and CRP (HR, 2.370) were factors related to decreased survival.
Conclusions: rTM treatment may have a positive impact on improving DIC and survival rates in patients with severe acute cholangitis.
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KEYWORD
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Recombinant soluble thrombomodulin, Disseminated intravascular coagulation, Acute cholangitis, Thrombosis
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