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Severe coagulopathy following intraoperative use of topical thrombin

Mark R Sarfati1, Daniel J Dilorenzo, Larry W Kraiss

  • 1Division of Vascular Surgery, University of Utah Health Sciences Center, Salt Lake City, UT 84103, USA. mark.sarfati@hsc.utah.edu

Annals of Vascular Surgery
|September 10, 2004
PubMed

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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