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Vitamin K-dependent proteins in patients undergoing head and neck free flap surgery - a prospective observational study

Persson, Karolina LU orcid ; Nilsson, Caroline Ulfsdotter LU ; Sjövall, Johanna LU ; Walther Sturesson, Louise LU ; Schurgers, Leon and Kander, Thomas LU orcid (2026) In Scandinavian Journal of Clinical and Laboratory Investigation p.1-9
Abstract

BACKGROUND/OBJECTIVES: Vitamin K dependent proteins are involved in numerous biological processes, including coagulation, cancer development and inflammation, but their profile and functions in many patient groups and conditions are still unknown. The aim of this study was to describe vitamin K dependent proteins in patients undergoing head and neck free flap surgery, with the hypothesis that these patients experience postoperative vitamin K deficiency.

METHODS: A prospective observational study including 39 patients undergoing extensive head and neck resection and reconstruction using free flap(s) was conducted with analyses of the γ-carboxyglutamic acid-containing proteins desphospho-uncarboxylated Matrix Gla Protein... (More)

BACKGROUND/OBJECTIVES: Vitamin K dependent proteins are involved in numerous biological processes, including coagulation, cancer development and inflammation, but their profile and functions in many patient groups and conditions are still unknown. The aim of this study was to describe vitamin K dependent proteins in patients undergoing head and neck free flap surgery, with the hypothesis that these patients experience postoperative vitamin K deficiency.

METHODS: A prospective observational study including 39 patients undergoing extensive head and neck resection and reconstruction using free flap(s) was conducted with analyses of the γ-carboxyglutamic acid-containing proteins desphospho-uncarboxylated Matrix Gla Protein (dp-uc-MGP), Growth arrest-specific gene 6 (Gas6) and Protein Induced by Vitamin K Absence/Antagonist for FII (PIVKA-II), as well as soluble Axl receptor (sAxl), on the day of surgery and postoperative (POD) days 1, 2 and 6. Changes from preoperative levels were explored using Kruskal-Wallis test with a Dunn's post hoc multiple comparison's test.

RESULTS: Gas6 showed a significant increase from preoperative levels to all postoperative days (POD1 and 2
p  < 0.001, POD6
p  = 0.002). For PIVKA-II a continuous increase was seen throughout the study period (POD1 ns, POD2 and 6
p  < 0.001). No significant changes were seen in dp-uc-MGP or sAxl levels.

CONCLUSIONS: Patients undergoing head and neck free flap surgery show signs of vitamin K deficiency during the first postoperative week.

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Please use this url to cite or link to this publication:
author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
Scandinavian Journal of Clinical and Laboratory Investigation
pages
1 - 9
publisher
Informa Healthcare
external identifiers
  • pmid:42364136
ISSN
1502-7686
DOI
10.1080/00365513.2026.2694050
language
English
LU publication?
yes
id
c8d68c6b-4787-412d-9d51-06b6e33049c9
date added to LUP
2026-06-29 08:02:47
date last changed
2026-06-29 08:11:27
@article{c8d68c6b-4787-412d-9d51-06b6e33049c9,
  abstract     = {{<p>BACKGROUND/OBJECTIVES: Vitamin K dependent proteins are involved in numerous biological processes, including coagulation, cancer development and inflammation, but their profile and functions in many patient groups and conditions are still unknown. The aim of this study was to describe vitamin K dependent proteins in patients undergoing head and neck free flap surgery, with the hypothesis that these patients experience postoperative vitamin K deficiency.</p><p>METHODS: A prospective observational study including 39 patients undergoing extensive head and neck resection and reconstruction using free flap(s) was conducted with analyses of the γ-carboxyglutamic acid-containing proteins desphospho-uncarboxylated Matrix Gla Protein (dp-uc-MGP), Growth arrest-specific gene 6 (Gas6) and Protein Induced by Vitamin K Absence/Antagonist for FII (PIVKA-II), as well as soluble Axl receptor (sAxl), on the day of surgery and postoperative (POD) days 1, 2 and 6. Changes from preoperative levels were explored using Kruskal-Wallis test with a Dunn's post hoc multiple comparison's test.</p><p>RESULTS: Gas6 showed a significant increase from preoperative levels to all postoperative days (POD1 and 2 <br>
 p  &lt; 0.001, POD6 <br>
 p  = 0.002). For PIVKA-II a continuous increase was seen throughout the study period (POD1 ns, POD2 and 6 <br>
 p  &lt; 0.001). No significant changes were seen in dp-uc-MGP or sAxl levels.<br>
 </p><p>CONCLUSIONS: Patients undergoing head and neck free flap surgery show signs of vitamin K deficiency during the first postoperative week.</p>}},
  author       = {{Persson, Karolina and Nilsson, Caroline Ulfsdotter and Sjövall, Johanna and Walther Sturesson, Louise and Schurgers, Leon and Kander, Thomas}},
  issn         = {{1502-7686}},
  language     = {{eng}},
  month        = {{06}},
  pages        = {{1--9}},
  publisher    = {{Informa Healthcare}},
  series       = {{Scandinavian Journal of Clinical and Laboratory Investigation}},
  title        = {{Vitamin K-dependent proteins in patients undergoing head and neck free flap surgery - a prospective observational study}},
  url          = {{http://dx.doi.org/10.1080/00365513.2026.2694050}},
  doi          = {{10.1080/00365513.2026.2694050}},
  year         = {{2026}},
}