Impact of genetic variation on perioperative bleeding.
Variation in bleeding in the perioperative period is a complex and multifactorial event associated with immediate and delayed consequences for the patient and health care resources. Little is known about the complex genetic influences on perioperative bleeding. With the discovery of multiple variations in the human genome and ever-growing databases of well-phenotyped surgical patients, better identification of patients at risk of bleeding is becoming a reality. In this review, polymorphisms in the platelet receptor genes, plasminogen activator inhibitor, and angiotensin genes among others will be discussed. We will explore the nature, effects, and implications of the genetics that influence perioperative bleeding above and beyond surgical bleeding, particularly in cardiac surgery.
Muehlschlegel
Jochen D
JD
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. jmuehlschlegel@partners.org
Body
Simon C
SC
D000809:Angiotensins / Q000235:genetics; D001779:Blood Coagulation Factors / Q000235:genetics; D001780:Blood Coagulation Tests; D016063:Blood Loss, Surgical / Q000503:physiopathology* / Q000517:prevention & control; D001798:Blood Proteins / Q000235:genetics; D006348:Cardiac Surgical Procedures; D020022:Genetic Predisposition to Disease; D014644:Genetic Variation; D005838:Genotype; D006474:Hemorrhagic Disorders / Q000175:diagnosis / Q000235:genetics* / Q000503:physiopathology; D006487:Hemostasis / Q000235:genetics* / Q000502:physiology; D006801:Humans; D015849:Plasminogen Inactivators / Q000235:genetics; D015539:Platelet Activation / Q000235:genetics; D011110:Polymorphism, Genetic; D019106:Postoperative Hemorrhage / Q000235:genetics* / Q000517:prevention & control; D012307:Risk Factors
D000809:Angiotensins; D001779:Blood Coagulation Factors; D001798:Blood Proteins; D015849:Plasminogen Inactivators