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Safer surgery using zymogen protein C concentrate.

Duane F Bruley1, Simon C Mears, Michael B Streiff

  • 1Synthesizer, Inc., 2773 Westminster Road, Ellicott City, MD 21043, USA. bruley@umbc.edu

Advances in Experimental Medicine and Biology
|March 6, 2010
PubMed
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Zymogen protein C (ZPC) concentrate was used peri-operatively for a high-risk patient with Protein C deficiency and a prothrombin gene mutation, preventing thrombosis with minimal bleeding. Further research is needed to optimize ZPC dosing for safety and efficacy.

Area of Science:

  • Biochemistry
  • Hematology
  • Medical Technology

Background:

  • A 74-year-old male with 50% Protein C deficiency, heterozygosity for the prothrombin gene mutation, and a history of Venous Thromboembolism (VTE) was at high risk for Deep Vein Thrombosis (DVT) during total left hip replacement.
  • The patient's history necessitated increased heparin, raising concerns for internal bleeding and infection.

Observation:

  • Peri-operative administration of Zymogen Protein C (ZPC) concentrate was implemented one day prior to and for ten days following surgery.
  • The ZPC concentrate was activated on the surface of endothelial cells and platelets, targeting activation where and when needed.
  • Protein C activity levels reached up to 235% above normal during the procedure.

Findings:

  • The procedure was achieved safely with minimal, slightly elevated blood loss and no dangerous side effects.

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  • The use of ZPC concentrate effectively decreased the risk of thrombosis.
  • Observed benefits included increased blood flow and oxygen transport, potentially due to reduced microcirculation sludging.

    • Implications:

    • ZPC concentrate should be considered for patients with a high probability of VTE to prevent thrombotic occlusion and subsequent organ failure.
    • Further studies are required to determine optimal Protein C dosage for economical, safe, and efficacious use.
    • Research efforts are underway to optimize bio-processing for lower-cost production of ZPC and activated Protein C for broader medical applications.