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Perioperative changes in PIVKA-II

Dauti, Fredrik; Hjaltalin Jonsson, Magnus LU ; Hillarp, Andreas LU ; Bentzer, Peter LU and Schött, Ulf LU (2015) In Scandinavian Journal of Clinical & Laboratory Investigation 75(7). p.562-567
Abstract
Background and aims. Proteins induced by vitamin K absence for factor II (PIVKA-II) is an enzyme-linked immunosorbent assay that monitors uncarboxylated prothrombin and responds to vitamin K deficits prior to changes in the prothrombin test. The aim of this project was to study perioperative PIVKA-II changes during various types of surgery in a prospective observational study. Methods. Patients undergoing abdominal or orthopaedic surgery were included. Blood was sampled on the day of surgery (preoperatively) and up to 5 days after surgery. The activated partial thromboplastin time, Quick and Owren prothrombin times were analyzed, together with PIVKA-II. Results. Thirty-nine patients were included, 27 male and 12 female. All but 7 patients... (More)
Background and aims. Proteins induced by vitamin K absence for factor II (PIVKA-II) is an enzyme-linked immunosorbent assay that monitors uncarboxylated prothrombin and responds to vitamin K deficits prior to changes in the prothrombin test. The aim of this project was to study perioperative PIVKA-II changes during various types of surgery in a prospective observational study. Methods. Patients undergoing abdominal or orthopaedic surgery were included. Blood was sampled on the day of surgery (preoperatively) and up to 5 days after surgery. The activated partial thromboplastin time, Quick and Owren prothrombin times were analyzed, together with PIVKA-II. Results. Thirty-nine patients were included, 27 male and 12 female. All but 7 patients had elevated PIVKA-II levels preoperatively. PIVKA-II levels had already increased significantly (p < 0.017) on day 1 after surgery as compared to presurgery plasma levels. The median PIVKA-II was highest on day 5. Routine tests were mostly normal. No significant difference in PIVKA-II was seen when comparing patients undergoing abdominal versus orthopaedic surgeries. There was no significant correlation between PIVKA-II and routine coagulation tests. Patients with anterior resection, emergency laparotomy and emergency hip fractures had higher postoperative increases, which could be linked to increased gastrointestinal recovery times, paralytic ileus, peritonitis and comorbidities. Conclusions. PIVKA-II levels increase during the perioperative period, despite mostly normal routine coagulation tests. Pre- and perioperative vitamin K supplementation in patients with elevated PIVKA-II levels should be studied, and its clinical significance be defined in future studies. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
PIVKA-II, vitamin K, prothrombin time, malabsorption, surgery
in
Scandinavian Journal of Clinical & Laboratory Investigation
volume
75
issue
7
pages
562 - 567
publisher
Informa Healthcare
external identifiers
  • wos:000361321700004
  • scopus:84940417358
ISSN
1502-7686
DOI
10.3109/00365513.2015.1058521
language
English
LU publication?
yes
id
a7ad30b3-173d-40ba-ba4d-dbd77db8bed5 (old id 8074246)
date added to LUP
2015-11-19 10:39:55
date last changed
2017-06-11 04:21:46
@article{a7ad30b3-173d-40ba-ba4d-dbd77db8bed5,
  abstract     = {Background and aims. Proteins induced by vitamin K absence for factor II (PIVKA-II) is an enzyme-linked immunosorbent assay that monitors uncarboxylated prothrombin and responds to vitamin K deficits prior to changes in the prothrombin test. The aim of this project was to study perioperative PIVKA-II changes during various types of surgery in a prospective observational study. Methods. Patients undergoing abdominal or orthopaedic surgery were included. Blood was sampled on the day of surgery (preoperatively) and up to 5 days after surgery. The activated partial thromboplastin time, Quick and Owren prothrombin times were analyzed, together with PIVKA-II. Results. Thirty-nine patients were included, 27 male and 12 female. All but 7 patients had elevated PIVKA-II levels preoperatively. PIVKA-II levels had already increased significantly (p &lt; 0.017) on day 1 after surgery as compared to presurgery plasma levels. The median PIVKA-II was highest on day 5. Routine tests were mostly normal. No significant difference in PIVKA-II was seen when comparing patients undergoing abdominal versus orthopaedic surgeries. There was no significant correlation between PIVKA-II and routine coagulation tests. Patients with anterior resection, emergency laparotomy and emergency hip fractures had higher postoperative increases, which could be linked to increased gastrointestinal recovery times, paralytic ileus, peritonitis and comorbidities. Conclusions. PIVKA-II levels increase during the perioperative period, despite mostly normal routine coagulation tests. Pre- and perioperative vitamin K supplementation in patients with elevated PIVKA-II levels should be studied, and its clinical significance be defined in future studies.},
  author       = {Dauti, Fredrik and Hjaltalin Jonsson, Magnus and Hillarp, Andreas and Bentzer, Peter and Schött, Ulf},
  issn         = {1502-7686},
  keyword      = {PIVKA-II,vitamin K,prothrombin time,malabsorption,surgery},
  language     = {eng},
  number       = {7},
  pages        = {562--567},
  publisher    = {Informa Healthcare},
  series       = {Scandinavian Journal of Clinical & Laboratory Investigation},
  title        = {Perioperative changes in PIVKA-II},
  url          = {http://dx.doi.org/10.3109/00365513.2015.1058521},
  volume       = {75},
  year         = {2015},
}