[A study of the effects of fresh frozen plasma to improve host defense against bacterial infection and levels of coagulation factors after hepatectomy].
Intraperitoneal infection and massive bleeding after hepatectomy often lead to liver failure. A possible cause of these complications may be the debasement of coagulation factors and opsonins in plasma after hepatectomy. The effects of fresh frozen plasma (FFP) to prevent these complications were investigated. 1) In the patients administered with more than 10 units/day of FFP after major hepatectomy, postoperative plasma opsonic activity was higher and the frequency of the intraperitoneal infection was lower than in the patients administered with smaller volume. In the former group, the activity of coagulation factors tended to increase postoperatively except for factor VII. But even the activity of factor VII was above critical level, and actually postoperative bleeding caused by coagulative insufficiency was not observed. 2) In the 70%-hepatectomized dogs, disappearance curve of intravenously injected Escherichia coli was biexponential. So two compartment model composed of circulating blood and phagocytic system was applied and velocity constants of the each phases of sequestration, reflux, and ingestion were calculated. The administration of FFP and opsonization of bacteria by normal plasma did not influence the phases of sequestration and reflux, but significantly accelerated the ingestion phase. The administration of FFP also increased survival rate after bacterial injection. These results suggest that FFP is effective on improving host defense against bacterial infection.
Ichikura
T
T
First Surgical Department, Faculty of Medicine, University of Tokyo, Japan.
D000368:Aged; D000818:Animals; D001424:Bacterial Infections / Q000097:blood / Q000276:immunology / Q000517:prevention & control*; D001779:Blood Coagulation Factors / Q000032:analysis*; D001803:Blood Transfusion / Q000379:methods; D004285:Dogs; D005260:Female; D006470:Hemorrhage / Q000097:blood / Q000517:prevention & control; D006498:Hepatectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009895:Opsonin Proteins / Q000032:analysis; D010587:Phagocytosis; D010949:Plasma; D011183:Postoperative Complications / Q000097:blood / Q000517:prevention & control*
D001779:Blood Coagulation Factors; D009895:Opsonin Proteins