title: The efficacy of the administration of recombinant human soluble thrombomodulin in patients with DIC.
abstract: Efficacy of recombinant human soluble thrombomodulin (rhTM), which is frequently used to treat patients with disseminated intravascular coagulation (DIC), was compared with that of gabexate mesilate (GM), which was previously used routinely in the treatment of DIC patients in Japan. Although there was no significant difference in the resolution rates of the patients who were treated with rhTM and GM, the results of our analysis revealed that the mortality rate was significantly higher among infectious disease patients treated with GM than in those treated with rhTM. Levels of fibrinogen and fibrin degradation products (FDP), antithrombin (AT) activity, and thrombin AT complex (TAT) were significantly lower in the DIC patients with infectious diseases, while fibrinogen levels were high. FDP level, D-dimer, platelet count, PT ratio, and DIC score all showed significant improvement following rhTM treatment. There were no significant difference between survivors and non-survivors in terms of DIC score, FDP level, platelet count, AT activity, or in TAT, SF and PPIC levels before rhTM treatment. However, fibrinogen levels were significantly lower in non-survivors than in survivors. These results indicate that rhTM may be superior to GM for the treatment of DIC.
authors.affiliation: Department of Hematology and Oncology, Mie University Graduate School of Medicine, Mie, Japan.
authors.forename: Takumi
authors.initials: T
authors.lastname: Aota
authors.affiliation: Departments of Molecular and Laboratory Medicine, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan. wadahide@clin.medic.mie-u.ac.jp.
authors.forename: Hideo
authors.initials: H
authors.lastname: Wada
authors.affiliation: Department of Hematology and Oncology, Mie University Graduate School of Medicine, Mie, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Yamashita
authors.affiliation: Blood Transfusion Service, Mie University Graduate School of Medicine, Mie, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Matsumoto
authors.affiliation: Blood Transfusion Service, Mie University Graduate School of Medicine, Mie, Japan.
authors.forename: Kohshi
authors.initials: K
authors.lastname: Ohishi
authors.affiliation: Emergency Critical Care Center, Mie University Graduate School of Medicine, Mie, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Suzuki
authors.affiliation: Emergency Critical Care Center, Mie University Graduate School of Medicine, Mie, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Imai
authors.affiliation: Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, Mie, Japan.
authors.forename: Masanobu
authors.initials: M
authors.lastname: Usui
authors.affiliation: Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, Mie, Japan.
authors.forename: Shuji
authors.initials: S
authors.lastname: Isaji
authors.affiliation: Department of Hematology and Oncology, Mie University Graduate School of Medicine, Mie, Japan.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Katayama
mesh_terms: D000328:Adult; D000368:Aged; D004211:Disseminated Intravascular Coagulation / Q000097:blood / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005340:Fibrinogen / Q000378:metabolism; D016670:Gabexate / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000008:administration & dosage; D012995:Solubility; D015996:Survival Rate; D018180:Thrombomodulin / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; D011994:Recombinant Proteins; C546931:THBD protein, human; D018180:Thrombomodulin; D016670:Gabexate; D005340:Fibrinogen
keywords: Deep vein thrombosis; Major bleeding; Orthopedic surgery; sGPVI