Gut Liver.  2018 Jul;12(4):471-477. 10.5009/gnl17489.

Clinical Impact of Recombinant Soluble Thrombomodulin for Disseminated Intravascular Coagulation Associated with Severe Acute Cholangitis

• Okuda A
• Ogura T
• Imanishi M
• Miyano A
• Nishioka N
• Higuchi K

• KMID: 2417315
• DOI: http://doi.org/10.5009/gnl17489

Abstract

BACKGROUND/AIMS
Recently, recombinant human soluble thrombomodulin (rTM) has been developed as a new drug for disseminated intravascular coagulation (DIC). This study aims to evaluate the clinical benefit of rTM in patients with sepsis-induced DIC caused by acute cholangitis who underwent biliary drainage.
METHODS
Patients were divided into two groups: the rTM therapy group and the non-rTM therapy group. The primary outcome was the DIC resolution rate at 7 days, and the secondary outcome was 28-day mortality rate.
RESULTS
Thirty-five patients were treated by rTM, and 36 patients were treated without rTM for DIC. The rate of resolution of DIC at day 7 was significantly higher in the rTM group than in the non-rTM group (82.9% vs 55.6%, p=0.0012). Compared with the non-rTM group, the 28-day survival rate of the r-TM group was significantly higher (rTM vs non-rTM, 91.4% vs 69.4%, p=0.014). According to multivariate analysis, non-rTM (hazard ratio [HR], 2.681) and CRP (HR, 2.370) were factors related to decreased survival.
CONCLUSIONS
rTM treatment may have a positive impact on improving DIC and survival rates in patients with severe acute cholangitis.

Keyword

Recombinant soluble thrombomodulin; Disseminated intravascular coagulation; Acute cholangitis; Thrombosis

MeSH Terms

Cholangitis*
Dacarbazine
Disseminated Intravascular Coagulation*
Drainage
Humans
Mortality
Multivariate Analysis
Survival Rate
Thrombomodulin*
Thrombosis
Dacarbazine
Thrombomodulin