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Ronald V. Maier, MD; Greg B. Hahnel, MS

Arch Surg. 1984;119(1):62-67.

Abstract
• The potential contribution of Kupffer's cells, ie, hepatic macrophages (HMs) to the diffuse microvascular thrombosis seen during septicemia was evaluated by measuring the ability of a homogeneous population of explanted HMs to express procoagulant activity (PCA). Addition of as little as 100 ng/mL of endotoxin stimulated a 30-fold increase over control values of PCA within eight hours. This PCA was membrane associated and functioned externally to the macrophage. Sensitivity to heat (56 °C) and diisopropyl fluorophosphate differentiated this PCA from typical tissue thromboplastin activity. The increase in PCA was blocked by pretreatment with warfarin sodium (a phytonadione blocker) and could be restored by addition of phytonadione. These studies showed that endotoxin induces in HMs a significant increase in PCA, functioning like coagulation factor VII. These results support a role for Kupffer's cells in the initiation of microvascular thrombosis in endotoxemia.

(Arch Surg 1984;119:62-67)

Author Affiliations
From the Department of Surgery, University of Washington, Seattle.

Footnotes
Accepted for publication Sept 14, 1983.

Read before the Third Annual Meeting of the Surgical Infection Society, Fort Lauderdale, Fla, May 10, 1983.

Reprint requests to Department of Surgery, ZA-16, Harborview Medical Center, Seattle, WA 98104 (Dr Maier).

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ABSTRACT