Safety and efficacy of a novel, dry powder fibrin sealant for hemostasis in hepatic resection

Dig Surg. 2014;31(6):422-7. doi: 10.1159/000370006. Epub 2015 Jan 14.

Abstract

Background/aims: Fibrocaps is a dry powder fibrin sealant containing human plasma-derived fibrinogen and thrombin. The safety, efficacy, and application methods for Fibrocaps were evaluated in an exploratory, first-in-human, noncomparative, clinical study.

Methods: Patients with minor bleeding/oozing after elective partial hepatic resection had Fibrocaps applied to the bleeding site either directly from the vial or from a spray device, with manual pressure applied using a cellulose, collagen, or gelatin sponge, if needed. Safety was evaluated at screening and postoperative days 1, 2, and 5, and weeks 4 and 12. The formation of anti-thrombin antibodies was assessed at baseline, and after 4 and 12 weeks. Time to hemostasis (TTH) within 10 min was determined.

Results: Twenty-nine patients were treated with Fibrocaps; 6 experienced serious adverse events that were not related to the course of treatment. Adverse events occurring in >10% of patients were nausea, constipation, hypotension, obstipation, hypokalemia, and postoperative pain. Most adverse events were mild or moderate in severity. No patient developed anti-thrombin antibodies. The percentage of patients who achieved hemostasis was 93%; the median TTH was 3.8 min (range 0.3-10.3). Manual pressure was applied with Fibrocaps in 19 patients and considered beneficial in most.

Conclusion: Fibrocaps was well tolerated in patients undergoing elective hepatic resection and resulted in rapid hemostasis. These safety and efficacy results support further clinical testing of this ready-to-use fibrin sealant as an adjunct to surgical hemostasis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antibodies / blood
  • Blood Loss, Surgical / prevention & control*
  • Female
  • Fibrin Tissue Adhesive / adverse effects
  • Fibrin Tissue Adhesive / therapeutic use*
  • Hemostasis, Surgical / methods*
  • Hemostatics / adverse effects
  • Hemostatics / therapeutic use*
  • Hepatectomy / adverse effects
  • Humans
  • Male
  • Middle Aged
  • Powders / adverse effects
  • Powders / therapeutic use*
  • Thrombin / immunology
  • Time Factors

Substances

  • Antibodies
  • Fibrin Tissue Adhesive
  • Hemostatics
  • Powders
  • Thrombin