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Severe Coagulopathy following Intraoperative Use of Topical Thrombin

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Annals of Vascular Surgery


This report describes a case of severe coagulopathy and bleeding related to the intraoperative use of topically applied thrombin. Commercial thrombin preparations contaminated with bovine factor V have been shown to stimulate the production of antibodies directed against factor V. These antibodies can cause coagulopathy. Our patient developed antibodies against factor V after intraoperative exposure to topical thrombin. The resulting antibody-mediated depletion of factor V caused a severe and refractory coagulopathy. Vascular surgeons should be aware that the use of topical bovine thrombin can cause severe coagulopathy.

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Correspondence to Mark R. Sarfati MD.

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Sarfati, M.R., DiLorenzo, D.J., Kraiss, L.W. et al. Severe Coagulopathy following Intraoperative Use of Topical Thrombin. Ann Vasc Surg 18, 349–351 (2004).

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