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ISSN 3061-8142 (Electronic)

2026, Number 3

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Rev Mex Anest 2026; 49 (3)

Factor XIII in anesthesiology and perioperative medicine: physiology, deficiencies, and clinical management

Pérez-Ajami D, Estupiñán-Valido E, Alegre-Cortés A, Pereira-Urquiza RY, Viscasillas-Navarro E

Language: Spanish
References: 20
Page: 162-167
PDF size: 932.23 Kb.


ABSTRACT

Factor XIII (FXIII) is a key transglutaminase in the final phase of coagulation, responsible for cross-linking fibrin and conferring mechanical stability and resistance to fibrinolysis to the clot. Its deficiency, whether congenital or acquired, is associated with persistent bleeding, poor wound healing, and increased surgical bleeding, often in the absence of abnormalities in conventional coagulation studies. This review rigorously presents the pathophysiology of FXIII deficiency, its clinical implications in anesthesiology and perioperative medicine, and the associated diagnostic challenges. Highly complex scenarios such as trauma, major burns, and cardiovascular, obstetric, and oncological surgery are analyzed, where FXIII deficiency negatively impacts hemostasis. The review also examines the usefulness of viscoelastic techniques, targeted replacement with plasma concentrates or recombinant FXIII, and the recommendations of international guidelines. Based on the available evidence, an individualized anesthetic approach is proposed for the early detection and treatment of FXIII deficiency, highlighting its role as a critical and frequently underestimated determinant in perioperative hemostatic safety.


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