Resolution of preoperative portal vein thrombosis after administration of antithrombin III in living donor liver transplantation: case report

Transplantation Proceedings
H ImaiS Uemoto

Abstract

A 59-year-old man with hepatitis C virus-associated liver cirrhosis was transferred to our hospital to undergo living donor liver transplantation. Coagulation was impaired (prothrombin time [International Normalized Ratio], 3.27), and antithrombin III (AT-III) activity was 23% (normal, 87%-115%). Contrast-enhanced computed tomography scans revealed portal vein thrombosis (PVT) from the junction between the splenic and superior mesenteric vein to the porta hepatica; the portal vein was completely obstructed (PVT). To prevent further development of PVT, 1500 U of AT-III was administered for 3 days, elevating the AT-III activity to 50%. A contrast-enhanced computed tomography scan obtained 9 days after AT-III administration showed resolution of PVT. Living donor liver transplantation was safely performed without portal vein grafting. Thus, a low AT-III concentration may have an important role in the pathogenesis of PVT in patients with cirrhosis.

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Citations

Nov 29, 2012·The American Journal of the Medical Sciences·Xingshun QiGuohong Han
Sep 14, 2017·Hepatology Research : the Official Journal of the Japan Society of Hepatology·Seiichiro KojimaKatsutoshi Obara
Jan 17, 2014·Industrial Health·Petra SmolkováVítězslav Kolek
Apr 25, 2020·Journal of Clinical Medicine·Hao-Chien HungWei-Chen Lee
Jul 1, 2017·Hepatology Research : the Official Journal of the Japan Society of Hepatology·Hisashi HidakaUNKNOWN NPB-06 study group

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