Given the frequent occurrence of disseminated intravascular coagulation after reinfusion of ascitic fluid in cirrhotic patients, a study involving a new ascites-apheresis apparatus was undertaken in 11 patients with decompensated liver cirrhosis and massive refractory ascites, with the aim of investigating activation of coagulation and fibrinolysis after the procedure. A large series of assays were performed in ascitic fluid and plasma before and after the apheresis sessions, and the measured values were compared with those expected and calculated on the basis of fluid and protein changes bound to the filtration and reinfusion procedures. In ascitic fluid, the measured values reflecting activation of blood clotting as prothrombin fragment 1+2 (F1+2) and thrombin-antithrombin complexes (TAT) although increased after filtration were much lower than expected. In plasma after reinfusion, F1+2 and TAT were also significantly less increased than calculated, presumably also because of their short half-life, while values reflecting activation of fibrinolysis as total, fibrin and fibrinogen degradation products were significantly increased above those calculated. Thus, the filtration-reinfusion system employed in this study appeared to efficiently remove most of the procoagulant materials from the ascitic fluid and did not significantly activate blood clotting in plasma. The observed activation of fibrinolysis was of limited extent as no relevant changes were observed in the basic clotting tests (PT and aPTT) and fibrinogen.
|Number of pages||6|
|Publication status||Published - 1996|
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