Surgery in patients with circulating lupus anticoagulant

Area of Science:

• Hematology
• Surgical Oncology

Background:

• The lupus anticoagulant (LA) is an antiphospholipid antibody associated with an increased risk of thrombosis.
• Its impact on surgical bleeding risk is not well-defined.

Purpose of the Study:

• To evaluate the intraoperative and postoperative bleeding risk in patients undergoing surgery with circulating lupus anticoagulant.

Main Methods:

• Retrospective review of twelve surgical procedures in eight patients with circulating lupus anticoagulant.
• Analysis of bleeding complications in relation to coexisting hemostatic defects such as hypoprothrombinemia and thrombocytopenia.

Main Results:

• Three patients experienced bleeding complications, all of whom also had hypoprothrombinemia and/or thrombocytopenia.
• Five patients with only circulating lupus anticoagulant (LA) had uneventful surgical courses.

Conclusions:

• Circulating lupus anticoagulant, in the absence of other hemostatic defects, is not a contraindication for surgery.
• Coexisting conditions like hypoprothrombinemia or thrombocytopenia significantly increase surgical bleeding risk in LA-positive patients.