Factor XIII Therapy of Anastomotic Leak, and Circulating Growth Factors

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Author(s)

    • Fujita Itsuo
    • Surgery for Organ Function and Biological Regulation (Surgery I), Nippon Medical School Graduate School of Medicine
    • Kiyama Teruo
    • Surgery for Organ Function and Biological Regulation (Surgery I), Nippon Medical School Graduate School of Medicine
    • Mizutani Takashi
    • Surgery for Organ Function and Biological Regulation (Surgery I), Nippon Medical School Graduate School of Medicine
    • Okuda Takeshi
    • Surgery for Organ Function and Biological Regulation (Surgery I), Nippon Medical School Graduate School of Medicine
    • Yoshiyuki Toshiro
    • Surgery for Organ Function and Biological Regulation (Surgery I), Nippon Medical School Graduate School of Medicine
    • Tokunaga Akira
    • Surgery for Organ Function and Biological Regulation (Surgery I), Nippon Medical School Graduate School of Medicine
    • Tajiri Takashi
    • Surgery for Organ Function and Biological Regulation (Surgery I), Nippon Medical School Graduate School of Medicine

Abstract

Wound healing is far more rapid in the gastrointestinal tract than in the skin. Once dehiscence of a surgical anastomosis in the gastrointestinal tract occurs, the high collagenase activity in the gastrointestinal tract may delay wound healing and promote the formation of a nonhealing fistula. Because factor XIII promotes cross-linking of fibrin during the early phase of wound healing, we investigated the effect of factor XIII concentrate on 16 anastomotic leaks and a nonhealing fistula. A 240-U dose of factor XIII concentrate (Fibrogammin P) was administrated intravenously for 5 days. Factor XIII activity and plasma levels of epidermal growth factor (EGF), transforming growth factor (TGF)-β, and interleukin-6 were measured before treatment and 1 day and 7 days after the end of treatment. Clinical outcomes were evaluated on the basis of the findings of contrast radiography, computed tomography, and drainage volume. Improvement relevant to the therapy was observed in 15 cases (88.2%). Factor XIII activity increased to more than 70% of the normal value in 11 cases (64.7%) but remained at 40% to 70% of the normal value in 6 cases (35.3%). Plasma EGF and TGF-βlevels increased in patients with improvement but were unchanged in patients without improvement. Our findings suggest that factor XIII significantly accelerates wound healing of anastomotic leaks and nonhealing fistulas by increasing circulating growth factors after systemic administration.<br>

Journal

  • Journal of Nippon Medical School

    Journal of Nippon Medical School 73(1), 18-23, 2006

    The Medical Association of Nippon Medical School

Codes

  • NII Article ID (NAID)
    130004146825
  • Text Lang
    ENG
  • ISSN
    1345-4676
  • Data Source
    J-STAGE 
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