Effects of nafamostat mesilate, a synthetic protease inhibitor, on immunity and coagulation after hepatic resection.
OBJECTIVE
Effects of nafamostat mesilate (NM), a serine protease inhibitor, on both coagulation-fibrinolysis activity and post-operative changes in immune responsiveness were investigated in a clinical study of 20 patients who underwent an extensive hepatic resection.


METHODS
The patients were randomly allocated into 2 groups of 10 patients each: The NM group was administered nafamostat mesilate (2 mg/kg/day) during and after the operation for 7 days. The control group received standard post-operative intensive therapies except NM.


RESULTS
The post-operative increase in coagulation in the control group was significantly suppressed in the NM-treated group on post-operative day (POD) 7. Natural killer (NK) activity, which was impaired after the operation, was recovered in the NM group on POD 7 and was significantly higher than in the control group. Helper/suppressor ratios of T lymphocytes were significantly increased post-operatively by the administration of NM.


CONCLUSIONS
These results demonstrate that NM controls the enhanced coagulation which occur in patients with extensive hepatic resection. It is also suggested that NM promptly restores the impaired immune responsiveness and decreases the risk of post-operative complications, as well as the risk of recurrence in patients with hepatic tumors.
Inagaki
H
H
Department of Surgery, Aichi Prefectural Hospital, Japan.
Nonami
T
T
Kurokawa
T
T
Takeuchi
Y
Y
Okuda
N
N
Nakao
A
A
Sakamoto
J
J
D000933:Antifibrinolytic Agents / Q000378:metabolism; D000990:Antithrombin III / Q000378:metabolism; D001550:Benzamidines; D001777:Blood Coagulation / Q000187:drug effects*; D016516:CD4-CD8 Ratio; D005260:Female; D005341:Fibrinolysin / Q000378:metabolism; D005342:Fibrinolysis / Q000276:immunology; D006146:Guanidines / Q000008:administration & dosage*; D006498:Hepatectomy; D006801:Humans; D007109:Immunity / Q000187:drug effects; D007262:Infusions, Intravenous; D015979:Killer Cells, Lymphokine-Activated / Q000276:immunology; D007694:Killer Cells, Natural / Q000276:immunology; D008113:Liver Neoplasms / Q000276:immunology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010447:Peptide Hydrolases / Q000378:metabolism; D012189:Retrospective Studies; D015842:Serine Proteinase Inhibitors / Q000008:administration & dosage*; D013601:T-Lymphocytes / Q000276:immunology; D000979:alpha-2-Antiplasmin
D000933:Antifibrinolytic Agents; D001550:Benzamidines; D006146:Guanidines; D015842:Serine Proteinase Inhibitors; D000979:alpha-2-Antiplasmin; C046193:antithrombin III-protease complex; C037742:plasmin-plasmin inhibitor complex; D000990:Antithrombin III; D010447:Peptide Hydrolases; D005341:Fibrinolysin; C032855:nafamostat