title: The hemostatic profiles of patients with Type O and non-O blood after acute normovolemic hemodilution with 6% hydroxyethyl starch (130/0.4).
abstract: BACKGROUND
  Individuals with Type O blood have been reported to have a tendency toward reduced Factor VIII and von Willebrand Factor (vWF) levels. If this is true, patients with Type O blood might be vulnerable to coagulopathy during acute normovolemic hemodilution using hydroxyethyl starch (HES), both from hemodilution as well as HES-related coagulopathy.
  
  
  METHODS
  Thirty non-O and 15 type O ASA 1 or 2 patients scheduled for spinal surgery involving more than two spinal levels were enrolled for the study. After anesthesia induction, 30% of the estimated blood volume was removed, and the volume was simultaneously replaced with 6% HES (130/0.4). Coagulation profiles were measured before (T0) and 30 min after acute normovolemic hemodilution (T30).
  
  
  RESULTS
  Factor VIII activity, vWF antigen levels (vWF:ag), and vWF ristocetin cofactor activity (vWF:RCof) were lower in the O group than in the non-O group before and after acute normovolemic hemodilution, and decreased below the normal range in the O group after acute normovolemic hemodilution. The decrease was beyond that expected from hemodilution alone. Maximum amplitude and coagulation index of the thromboelastogram decreased below the normal range in the O group after acute normovolemic hemodilution. The decrease in vWF:ag was related to the degree of blood loss, and was greater in patients in the O group.
  
  
  CONCLUSIONS
  Patients with Type O blood may have increased coagulation compromise, and greater dilution of Factor VIII activity, vWF:ag, and vWF:RCof after acute normovolemic hemodilution with HES.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Jin Gu
authors.initials: JG
authors.lastname: Kang
authors.forename: Hyun Joo
authors.initials: HJ
authors.lastname: Ahn
authors.forename: Gaab Soo
authors.initials: GS
authors.lastname: Kim
authors.forename: Tae Soo
authors.initials: TS
authors.lastname: Hahm
authors.forename: Jeong Jin
authors.initials: JJ
authors.lastname: Lee
authors.forename: Mi Sook
authors.initials: MS
authors.lastname: Gwak
authors.forename: Soo Joo
authors.initials: SJ
authors.lastname: Choi
mesh_terms: D000017:ABO Blood-Group System; D000328:Adult; D000368:Aged; D000941:Antigens / Q000032:analysis; D016063:Blood Loss, Surgical / Q000517:prevention & control; D005169:Factor VIII / Q000032:analysis; D005260:Female; D006438:Hemodilution; D006487:Hemostasis; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D014841:von Willebrand Factor / Q000276:immunology
chemical_list: D000017:ABO Blood-Group System; D000941:Antigens; D006895:Hydroxyethyl Starch Derivatives; C029417:Von Willebrand antigen; D014841:von Willebrand Factor; D005169:Factor VIII