Effectiveness of coagulation factor XIII concentrate for reversing loss of tensile strength of rat intestinal anastomoses

BACKGROUND: Blood coagulation factor XIII (F-XIII) promotes cross-linking of fibrin during blood coagulation. Impaired clot stabilization in patients with genetic deficiencies of F-XIII is associated with marked pathologies of wound healing. METHODS: 60 rats given carbon tetrachloride underwent ileal anastomosis after which they received albumin (Alb animals) or F-XIII concentrate (F-XIII animals) immediately after surgery and daily thereafter until day 2 or 4 and were euthanized on day 3 or 5, respectively, or until day 5 and were euthanized on day 7, 10, or 21. We measured the plasma F-XIII activity and anastomotic tensile strength, followed by immunohistochemical localization of F-XIII subunit A within anastomoses. RESULTS: On day 3, there were no significant differences between Alb and F-XIII animals for plasma F-XIII activity and tensile strength, and both groups of animals showed little immunostaining for F-XIII on anastomoses. Plasma F-XIII activities did not differ between Alb and F-XIII animals on day 5 (115.8 +/- 16.8 vs. 137.3 +/- 14.9%). Although the tensile strength in both groups was increased compared with that of day 3, that in F-XIII animals (129.8 +/- 3.3 gf) was significantly higher than that in Alb animals (100.8 +/- 5.3 gf, p = 0.014). F-XIII animals showed de novo collagen fibers and intense immunoreactivity of F-XIII in the extracellular matrix around the anastomoses. Similar differences occurred on day 7 but not days 10 and 21. CONCLUSIONS: F-XIII concentrate may accelerate the early healing process of intestinal anastomosis because of the protein's accumulation in situ.