Fibrin Glue May Have Transmitted HCV | Hepatitis Central

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Fibrin Glue May Have Transmitted HCV

The Editors at Hepatitis Central
January 17, 2008

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Used in Japan in the 1980s, a surgical adhesive made from fibrin is another suspect for the transmission of Hepatitis C. Primarily utilized for treating burns, nosebleeds and to aid in plastic surgery, fibrin glue may have been tainted with HCV-infected fibrinogen before proper testing was conducted.

Fibrin glue used for burns, facelifts

The Yomiuri Shimbun
www.yomiuri.co.jp

Fibrin glue, a surgical adhesive linked to the transmission of the hepatitis C virus, was used in a wide variety of areas, such as dealing with burns, stopping nosebleeds or in plastic surgery, according to doctors and other sources.

The tainted glue is estimated to have been used on about 79,000 patients, and those infected with the virus via the glue are eligible for relief under a law enacted Friday offering blanket relief to HCV suffers who contracted the disease through tainted blood products.

However, many patients do not realize the wide extent of the glue’s use, causing delays in the investigation into how many patients have been infected with the virus via the glue. “The Health, Labor and Welfare Ministry should alert the public by announcing the names of hospitals that used the glue and for what kind of treatment the glue was often used,” said Shiro Iino, former health ministry official in charge of research into issues concerning hepatitis.

The contaminated glue was made from a combination of substances including HCV-tainted fibrinogen manufactured by the defunct Green Cross Corp. mainly between 1981 and 1987. The glue was mostly used for stopping bleeding or as an adhesive during surgery. While it was not formally approved under the Pharmaceutical Affairs Law, Green Cross promoted the glue by issuing a booklet that gave details of how the glue could be used, resulting in many hospitals using it.

A private hospital in western Japan started using the glue from around 1982 as a surgical adhesive when it conducted major skin grafts on patients who had suffered severe burns. “As the glue had hemostatic and adhesive properties, we could conduct surgery quickly. I think we used the glue in treating between 10 to 20 patients a year,” a doctor at the hospital said.

The hospital stopped using the glue in the late 1980s, when the risk of hepatitis infection came to light. They have not confirmed any cases of HCV infection via the glue.

“We no longer have the medical records of the patients as the storage term has already expired. But I think it’s possible some patients will have contracted HCV via the glue as it was applied directly to the surface of the burned skin,” the doctor said. “What has happened to those patients subsequently is a concern.”

Meanwhile, a doctor in the ear, nose and throat department of another hospital in western Japan used the glue in the mid-1980s to treat patients suffering from nosebleeds. When it was difficult to identify from which part of the nose a patient was bleeding, the doctor filled the nose with the glue to stop the bleeding. The treatment was conducted on about 20 patients.

Several years ago, the doctor informed patients about the possibility of infection, and recommended them to undergo medical tests. But results obtained did not show any infection.

“As the glue was removed from the nose after treatment, that might have lowered the infection risk,” the doctor said.

In the 1980s, the glue was also used in plastic surgery. According to an academic journal, an aesthetic plastic surgeon in Tokyo used the glue as a hemostatic agent or as a surgical adhesive in facelift operations.

According to a report submitted in 2001 to the Health, Labor and Welfare Ministry by the then Welfide Corp., which took over Green Cross, the glue was used in about 270 medical procedures, including some related to the treatment of pneumothorax and stomach ulcers.

(Jan. 15, 2008)

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