Protein C in a patient with portal vein thrombosis in liver transplantation
https://doi.org/10.23873/2074-0506-2021-13-2-151-157
Abstract
Background. The problem of thromboses, including those associated with impaired hemostasis system, is relevant in orthotopic liver transplantation.
Aim. To present the experience of intraoperative use of protein C during orthotopic liver transplantation in a patient with a high risk of recurrent portal vein thrombosis.
Results. During orthotopic liver transplantation in a patient with a high risk of recurrent portal vein thrombosis, the intraoperative administration of the protein C preparation at a dosage of 500 IU contributed to the increase in plasma level of protein C by 48%. In the post-transplant period, recurrent portal vein thrombosis was not observed.
Conclusion. Intraoperative administration of protein C in combination with basic therapy for orthotopic liver transplantation helps to prevent recurrent portal vein thrombosis.
About the Authors
S. V. Zhuravel
N.V. Sklifosovsky Research Institute for Emergency Medicine
Russian Federation
Russian Federation
Sergey V. Zhuravel, Dr. Sci. (Med.), Head of the Scientific Department for Anesthesiology, Intensive and Critical Care
3 Bolshaya Sukharevskaya Sq., Moscow 129090
V. E. Aleksandrova
N.V. Sklifosovsky Research Institute for Emergency Medicine
Russian Federation
Russian Federation
Viktoriya E. Aleksandrova, Anesthesiologist-reanimatologist, Junior Researcher of the Anesthesiology Department
3 Bolshaya Sukharevskaya Sq., Moscow 129090
N. K. Kuznetsova
N.V. Sklifosovsky Research Institute for Emergency Medicine
Russian Federation
Russian Federation
Natalya K. Kuznetsova, Cand. Sci. (Med.), Anesthesiologist-reanimatologist, Leading Researcher of the Anesthesiology Department
3 Bolshaya Sukharevskaya Sq., Moscow 129090
M. S. Novruzbekov
N.V. Sklifosovsky Research Institute for Emergency Medicine
Russian Federation
Russian Federation
Murad S. Novruzbekov, Dr. Sci. (Med.), Head of the Scientific Department for Liver Transplantation
3 Bolshaya Sukharevskaya Sq., Moscow 129090
L. V. Donova
N.V. Sklifosovsky Research Institute for Emergency Medicine
Russian Federation
Russian Federation
Lyubov V. Donova, Cand. Sci. (Med.), Senior Researcher of the Liver Transplantation Department
3 Bolshaya Sukharevskaya Sq., Moscow 129090
References
1. Mantaka А, Augoustaki А, Kouroumalis EA, Samonakis DN. Portal vein thrombosis in cirrhosis: diagnosis, natural history, and therapeutic challenges. Ann Gastroenterol. 2018;31(3):315-329. https://doi.org/10.20524/aog.2018.0245
2. Hrishikesh S, Kwabena OA-А, Karen G. Portal vein thrombosis. Treasure Island (FL): StatPearls Publishing; 2020. Available at: https://www.ncbi.nlm.nih.gov/books/NBK534157/ [Accessed April 1, 2021].
3. Derksen WJM, de Jong I, Buis CI, Reyntjens KМ, Kater MG, Korteweg T, et al. Successful thrombectomy via a surgically reopened umbilical vein for extended Portal vein thrombosis caused by Portal vein embolization prior to extended liver resection. Case Rep Gastroenterol. 2020;14(2):320–328. https://doi.org/10.1159/000508743
4. Harding DJ, Perera MTh, Chen F, Olliff S, Tripathi Dh. Portal vein thrombosis in cirrhosis: Controversies and latest developments. World J Gastroenterol. 2015;21(22):6769–6784. https://doi.org/10.3748/wjg.v21.i22.6769
5. Zhuravel SV, Utkina II, Zhuravel NS, Kuznetsova NK. Diagnosis and therapy of the hemostatic system disorders in liver transplantation. Transplantologiya. The Russian Journal of Transplantation. 2017;9(3):252–255. (In Russ.). https://doi.org/10.23873/2074-0506-2017-9-3-252-255
6. Hirata Y, Sanada Y, Omameuda T, Katano T, Miyahara G, Yamada N, et al. Antithrombin III treatment for portal vein thrombosis after living donor liver transplantation: a case report. Surg Case Rep. 2020;6(1):159. https://doi.org/10.1186/s40792-020-00920-y
7. Suda T, Takatori H, Hayashi T, Horii R, Nio K, Terashima T, et al. Investigation of thrombosis volume, anticoagulants, and recurrence factors in Portal vein thrombosis with cirrhosis. Life (Basel). 2020;10(9):177. https://doi.org/10.3390/life10090177
8. Reshetnyak VI, Zhuravel SV, Kuznetsova NK, Pisarev VМ, Klychnikova EV, Syutkin VЕ, et al. The system of blood coagulation in normal and in liver transplantation (review). General Reanimatology. 2018;14(5):58–84. (In Russ.). https://doi.org/10.15360/1813-9779-2018-5-58-84
9. Filonik DYu, Savchuk MM, Scherba AE, Rummo OO. Vascular complications development after orthotopic liver transplantation. Medical Journal. 2014;2(48):34–39. (In Russ.).
10. Gupta A, Patibandla S. Protein C Deficiency Ashish G. Treasure Island (FL): StatPearls Publishing; 2020. Available at: https://www.ncbi.nlm.nih.gov/books/NBK542222/ [April 1, 2021].
11. Delahousse B, Labat-Debelleix V, Decalonne L, d’Alteroche L, Perarnau JM, Gruel Y. Comparative study of coagulation and thrombin genera tion in the portal and jugular plasma of patients with cirrhosis. Thromb Haemost. 2010;104(4):741-749. https://doi.org/10.1160/TH10-01-0040
12. Kogan AE, Strukova SM. Protein S: mekhanizm aktivatsii i antikoagulyantnogo deystviya. Biochemistry (Moscow). 1993;58(6):827–844. (In Russ.).
13. Rosendal FR, Reitsma PH. Genetics of venous thrombosis. J Thromb Haemost. 2009;7(Suppl 1):301–304. https://doi.org/10.1111/j.1538-7836.2009.03394.x
14. Goncharov AA, Rybka MM, Khinchagov DY, Rogalskaya EA. A clinical case of protein C deficiency revealed in a patient during surgery for cyanotic heart defect. Russian journal of hematology and transfusiology. 2020;65(1):61–69. (In Russ.). https://doi.org/10.35754/02345730-2020-65-1-61-69
15. Morrow GB, Beavis J, Harper S, Baker P, Desborough MJR, Curry N, et al. Coagulation status of critically ill patients with and without liver disease assessed using a novel thrombin generation analyzer. J Thromb Haemost. 2020;18(7):1576–1585. https://doi.org/10.1111/jth.14802
Review
For citations:
Zhuravel S.V., Aleksandrova V.E., Kuznetsova N.K., Novruzbekov M.S., Donova L.V. Protein C in a patient with portal vein thrombosis in liver transplantation. Transplantologiya. The Russian Journal of Transplantation. 2021;13(2):151-157. https://doi.org/10.23873/2074-0506-2021-13-2-151-157
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