Autotransfused shed mediastinal blood has normal erythrocyte survival

The anticoagulant action of Anisakis simplex larvae on human blood in vitro was examined. Anticoagulant activity was assessed by routine screening tests that evaluate the overall competency of the coagulant mechanism. A slight prolongation of the prothrombin time (PT) was observed with the larval crude extracts. Prolongation of the PT was seen at a concentration of excretory/secretory (ES) products greater than 62.5 micrograms/ml. No prolongation of the activated partial thromboplastin time (PTT) was observed using crude extracts. There was a prolongation of the PTT with ES products at concentrations greater than 62.5 micrograms/ml. ES products of the larvae were able to prolong coagulation times indicating that they contain an inhibitory or anticoagulant property. Preparation of crude extracts of A. simplex showed only minimal anticoagulant activity. The results obtained by measurements of the PT and the PTT suggest a probable alteration of one of the coagulation proteins namely factors Xa, IIa or Va. These findings suggest that the anticoagulant activity demonstrated in the ES products may play an important role during invasion of the gastric or intestinal mucosa by larvae and could have biological significance in infected patients.