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The Journal of Thoracic and Cardiovascular Surgery, Vol 97, 235-239, Copyright © 1989 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
RK Wenger, H Lukasiewicz, BS Mikuta, S Niewiarowski and LH Edmunds Jr
In 10 patients, cardiopulmonary bypass decreased the number of fibrinogen
binding sites from 31,730 +/- 12,802 per platelet to 18,590 +/- 9,644 per
platelet. Bypass also decreased the amount of the platelet membrane
glycoprotein IIIa, which is part of the fibrinogen receptor complex, from
17.1 +/- 3.6 ng/10(9) platelets to 12.9 +/- 4.7. The fibrinogen binding
constant did not change. Platelet sensitivity to adenosine diphosphate did
not change; however, template bleeding times increased from 5.2 +/- 1.5
minutes before bypass to 8.5 +/- 2.3 minutes after bypass. Analysis of
detergent washings from the perfusion circuit after bypass in five patients
indicated that platelet material remains attached to the surface as
membrane fragments and degranulated platelets. These data further elucidate
the mechanism of platelet loss and dysfunction during cardiopulmonary
bypass and highlight the importance of platelet membrane fibrinogen
receptors and surface adsorbed fibrinogen in this process.
ARTICLES
Loss of platelet fibrinogen receptors during clinical cardiopulmonary bypass
Department of Surgery, School of Medicine, University of Pennsylvania, Philadelphia.
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