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Thromb Haemost 1995; 74(06): 1447-1451
DOI: 10.1055/s-0038-1649963
Original Articles
Coagulation
Schattauer GmbH Stuttgart

Gelatin Use Impairs Platelet Adhesion during Cardiac Surgery

Norlyuki Tabuchi
The Department of Cardlothoraclc Surgery, University Hospital Groningen, The Netherlands
,
Jacob de Haan
The Department of Cardlothoraclc Surgery, University Hospital Groningen, The Netherlands
,
Rolf C G Gallandat Huet
1   The Department of Anesthesiology, Section of Cardlothoraclc Anesthesia, University Hospital Groningen, The Netherlands
,
Plet W Boonstra
The Department of Cardlothoraclc Surgery, University Hospital Groningen, The Netherlands
,
Willem van Oeveren
The Department of Cardlothoraclc Surgery, University Hospital Groningen, The Netherlands
› Author Affiliations
Further Information

Publication History

Received 22 November 1994

Accepted after resubmission 16 August 1995

Publication Date:
10 July 2018 (online)

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Summary

Artificial colloids based on gelatin are used as plasma expander to replace donor blood products. In laboratory experiments, gelatin reduced both the velocity and extend of platelet agglutination by ristocetin, and only the agglutination velocity by polybrene (p <0.05). Furthermore, gelatin delayed the in-vitro platelet plug formation under shear-stress in the absence of ADP (p <0.05), whereas gelatin induced no delay in the presence of ADP. Thus, after induction of vWF release from platelets by polybrene or ADP, platelet function was normal. These results indicate that gelatin affects in particular the functionality of plasma-vWF and partly inhibits platelet adhesion.

These negative effects of gelatin on hemostasis were demonstrated in two clinical studies during cardiac surgery. In a randomized study of sixty patients undergoing cardiac surgery, gelatin as prime in the heart-lung machine appeared to result in diminished efficacy of aprotinin on hemostasis, whereas it did not affect hemostasis in non-aprotinin patients. An additional retrospective clinical study showed that only high dose of gelatin affected hemostasis. This suggests a limited role of plasma-vWF and a strong back-up mechanism of platelet-vWF in achieving hemostasis.

 

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