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  • Title: Resolution of preoperative portal vein thrombosis after administration of antithrombin III in living donor liver transplantation: case report.
    Author: Imai H, Egawa H, Kajiwara M, Nakajima A, Ogura Y, Hatano E, Ueda M, Kawaguchi Y, Kaido T, Takada Y, Uemoto S.
    Journal: Transplant Proc; 2009 Nov; 41(9):3931-3. PubMed ID: 19917415.
    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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