Srpski arhiv za celokupno lekarstvo 2012 Volume 140, Issue 11-12, Pages: 782-785
https://doi.org/10.2298/SARH1212782V
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PFA-100 test in the detection of platelet dysfunction and monitoring DDAVP in a patient with liver cirrhosis undergoing inguinal hernia repair
Vučelić Dragica (Klinika za digestivnu hirurgiju, Klinički centar Srbije, Beograd)
Golubović Milka (Centar za medicinsku biohemiju, Klinički centar Srbije, Beograd)
Bjelović Miloš (Klinika za digestivnu hirurgiju, Klinički centar Srbije, Beograd + Medicinski fakultet, Beograd)
Introduction. Hemostatic abnormalities in liver cirrhosis are complex and
multifactorial and may predispose to prolonged hemorrhage following invasive
procedures. Due to increased perioperative bleeding risks, patients with
cirrhosis should undergo elective surgery after making medical preparations.
It has been shown that 1-deamino-8-D-arginine vasopressin (DDAVP),
desmopressin, can be used as a safe and effective remedy in preventing and
treating bleeding in cirrhotics. However, there is still scarce information
of adequate test(s) for assessing effects of DDAVP in platelet dysfunction.
The use of platelet function analyzer-100 (PFA-100) allows more reliable
assessment of impaired primary hemostasis as well as follow-up of hemostatic
changes induced by DDAVP effects. Case Outline. In a 49-year-old male with
ethylic liver cirrhosis and prolonged bleeding time scheduled for elective
left side inguinal hernia repair, we carried out PFA-100 testing to
investigate the patient’s platelet functional status. Results were
affirmative for the presence of platelet functional problems. By standard
coagulation tests the patient was also identified as having secondary
hemostasis. Preoperatively, PFA-100 was used to test the patient’s response
to a standard dose of DDAVP, which was favorable. The patient was operated
after medical preparations with DDAVP and vitamin K. Neither bleeding
complications nor side effects of DDAVP were recorded in the perioperative
period. Conclusion. The PFA-100 is a simple and reliable test for the
assessment of primary hemostasis as well as in monitoring of DDAVP therapy.
Keywords: platelet dysfunction, liver cirrhosis, surgery, PFA-100, DDAVP