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Updated: Jul 6, 2026
13:08
Measurement of Factor V Activity in Human Plasma Using a Microplate Coagulation Assay
Published on: September 9, 2012
[Thrombelastometric detection of factor XIII deficiency]
C F Weber1, C Jambor, M Marquardt
1Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Johann Wolfgang Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt. weber@med.uni-frankfurt.de
Der Anaesthesist
|March 14, 2008
Summary
A patient experienced severe bleeding during surgery due to a factor XIII deficiency. Prompt administration of factor XIII concentrate effectively stopped the bleeding, highlighting its importance in surgical hemostasis.
Area of Science:
- Coagulation science
- Surgical hemostasis
- Thrombelastometry
Background:
- The Whipple operation (pancreaticoduodenectomy) is a complex surgical procedure.
- Uncontrolled bleeding can be a serious complication during major abdominal surgery.
- Coagulation factor deficiencies can significantly impair hemostasis.
Observation:
- A patient undergoing a Whipple operation experienced unexpected diffuse bleeding and significant blood loss.
- Intraoperative rotational thromboelastometry (ROTEM) indicated mild, aprotinin-resistant fibrinolysis.
- ROTEM analysis suggested an isolated deficiency of coagulation factor XIII.
Findings:
- In vitro substitution with factor XIII in a second ROTEM test eliminated lysis, confirming the diagnosis.
- Postoperative analysis confirmed a significant factor XIII deficiency (52%).
- Intravenous administration of 1250 IU of factor XIII concentrate successfully controlled the intraoperative bleeding.
Implications:
- Factor XIII deficiency can manifest as severe bleeding during major surgery.
- Intraoperative thrombelastometry (ROTEM) is a valuable tool for diagnosing coagulation disorders during surgery.
- Timely factor XIII concentrate administration can effectively manage bleeding in factor XIII deficient patients, avoiding the need for other blood products.
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