Document Detail

Decreased ADAMTS13 levels in patients after living donor liver transplantation.
MedLine Citation:
PMID:  19423151     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Thrombotic microangiopathy (TMA) is a complication occurring after liver transplantation (LT), and an unusually large multimer (ULM) of Von Willebrand factor (VWF) and ADAMTS13 may play an important role in the onset of TMA during LT. MATERIAL AND METHODS: Eight-one patients underwent living donor LT (LDLT). Seventeen of those patients had both severe thrombocytopenia and hemolytic anemia with fragmented red cells and were diagnosed as TMA- like syndrome (TMALS). RESULTS AND CONCLUSIONS: A significant reduction of ADAMTS13 and an increase of VWF were observed in the patients with TMALS. The ADAMTS13 activity in patients after LDLT was significantly reduced from day 1 to day 21, and it was significantly low in those with TMALS at day 14 and 28. The VWF levels in patients with LDLT were significantly high, and the VWF/ADAMTS13 ratio was significantly increased in patients at 7, 14 and 28 days after LDLT, especially in patients with TMALS at day 14 and 28 after LDLT. High molecular weight multimers of VWF were observed to have increased in patients with LDLT, and the high molecular weight multimers of VWF were further increased in those with mild TMALS but they decreased in those with severe TMA. These findings suggest that ULM- VWF and ADAMTS13 might be associated with the onset of TMA after LT.
Toshihiko Kobayashi; Hideo Wada; Masanobu Usui; Hiroyuki Sakurai; Takeshi Matsumoto; Tsutomu Nobori; Naoyuki Katayama; Sinji Uemoto; Hiromichi Ishizashi; Masanori Matsumoto; Yoshihiro Fujimura; Shuji Isaji
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-05-06
Journal Detail:
Title:  Thrombosis research     Volume:  124     ISSN:  1879-2472     ISO Abbreviation:  Thromb. Res.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-19     Completed Date:  2010-02-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0326377     Medline TA:  Thromb Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  541-5     Citation Subset:  IM    
Departments of Hematology, Mie University Graduate School of Medicine, Mie, Japan.
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MeSH Terms
ADAM Proteins / blood*
Liver Transplantation / adverse effects*
Middle Aged
Thrombotic Microangiopathies / blood*,  etiology*
von Willebrand Factor / metabolism
Reg. No./Substance:
0/von Willebrand Factor; EC 3.4.24.-/ADAM Proteins; EC 3.4.24.-/ADAMTS13 protein, human

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