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Please use this identifier to cite or link to this item: http://hdl.handle.net/10564/3745

Title: Ischaemia-reperfusion injury with Pringle's maneuver induces unusually large von Willebrand factor multimers after hepatectomy.
Other Titles: Pringle法に伴う虚血再灌流障害はUnusually Large Von Willebrand Factor Multimersを誘導する
Authors: Yoshikawa, Takahiro
Nomi, Takeo
Sakai, Kazuya
Hayakawa, Masaki
Hokuto, Daisuke
Matsuo, Yasuko
Sho, Masayuki
Matsumoto, Masanori
Keywords: ADAMTS13
Unusually large VWF multimers
Hepatectomy
Issue Date: Nov-2019
Publisher: Elsevier
Citation: Thrombosis research Vol.183 p.20-27 (2019 Nov)
Abstract: Introduction: von Willebrand factor (VWF) is synthesised in vascular endothelial cells and released into the plasma as unusually large VWF multimers (UL-VWFMs). Sinusoidal endothelial cells are a major target of ischaemia-reperfusion injury due to liver surgery. This study aimed to clarify the effect of hepatectomy on UL-VWFMs. Materials and methods: Thirty-five patients who underwent hepatectomy were eligible for the study. Plasma ADAMTS13 activity and VWF antigen levels were measured by enzyme-linked immunosorbent assay and multimer analysis of plasma VWF was performed according to Ruggeri and Zimmerman's method. For analyses, patients were categorised according to UL-VWFM positivity after hepatectomy. Results: Plasma ADAMTS13 activity significantly decreased from 61.0% (27.7%-126.2%) before operation to 37.4% (20.2%-71.4%) on postoperative day 7 (p < 0.001). Plasma VWF antigen levels significantly increased from 172.1% (80.5%-412.8%) before operation to 361.0% (154.7%-745.8%) on postoperative day 2, which remained high until postoperative day 7 (p < 0.001). Seven patients remained UL-VWFMs-negative and 22 patients became UL-VWFMs-positive after operation. Pringle's maneuver duration was significantly longer and blood loss volume was significantly higher in the UL-VWFMs-positive group (p = 0.001 and p = 0.003, respectively). By multivariable analysis, Pringle's maneuver duration [odds ratio 1.049, 95% confidence interval (CI) 1.001-1.098; p = 0.043] was significantly associated with increased UL-VWFMs level after hepatectomy. UL-VWFMs index was significantly correlated with Pringle's maneuver duration (r = 0.444, p = 0.017). Conclusions: Plasma UL-VWFMs levels increased after hepatectomy due to ischaemia-reperfusion injury with Pringle's maneuver.
Description: 博士(医学)・乙第1455号・令和2年3月16日
Copyright © 2019 Elsevier Ltd. All rights reserved.
URI: http://hdl.handle.net/10564/3745
ISSN: 00493848
Academic Degrees and number: 24601B1455
Degree-granting date: 2020-03-16
Degree name: 博士(医学)
Degree-granting institutions: 奈良県立医科大学
Appears in Collections:2019年度

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