Document Detail


Impact of antithrombin III concentrates on portal vein thrombosis after splenectomy in patients with liver cirrhosis and hypersplenism.
MedLine Citation:
PMID:  19864937     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The aim of this study was to determine the role of antithrombin III (AT-III) in portal vein thrombosis (PVT) after splenectomy in cirrhotic patients. SUMMARY BACKGROUND DATA: There is no standard treatment for PVT after splenectomy in liver cirrhosis. METHODS: A total of 50 consecutive cirrhotic patients who underwent laparoscopic splenectomy for hypersplenism were enrolled into this study. From January 2005 to December 2005, 25 cirrhotic patients received no prophylactic anticoagulation therapy after the operation (AT-III [-] group). From January 2006 to July 2006, 25 cirrhotic patients received prophylactic administration of AT-III concentrates (1500 U/d) on postoperative day (POD) 1, 2, and 3 (AT-III [+] group). RESULTS: In AT-III (-) group, 9 (36.0%) patients developed PVT up to POD 7, and risk factors for PVT were identified as: low platelet counts, low AT-III activity, and increased spleen weight. Although there were no significant differences in the clinical characteristics, including the above risk factors, between the 2 groups, only 1 (4.0%) patient developed PVT on POD 30 in AT-III (+) group, and the incidence of PVT was significantly lower than in AT-III (-) group (P = 0.01). In AT-III (-) group, AT-III activity was significantly decreased from POD 1 to POD 7, as compared with the preoperative level, whereas AT-III concentrates prevented the postoperative decrease in AT-III activity. CONCLUSIONS: These results demonstrate that low AT-III activity and further decreases in this activity are associated with PVT after splenectomy in cirrhotic patients, and that treatment with AT-III concentrates is likely to prevent the development of PVT in these patients.
Authors:
Hirofumi Kawanaka; Tomohiko Akahoshi; Nao Kinjo; Kozou Konishi; Daisuke Yoshida; Go Anegawa; Shohei Yamaguchi; Hideo Uehara; Naotaka Hashimoto; Norifumi Tsutsumi; Morimasa Tomikawa; Yoshihiko Maehara
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of surgery     Volume:  251     ISSN:  1528-1140     ISO Abbreviation:  Ann. Surg.     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-29     Completed Date:  2010-01-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  76-83     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. harrykw@v102.vaio.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anticoagulants / administration & dosage*,  therapeutic use
Antithrombin III / administration & dosage*,  analysis
Female
Fibrin Fibrinogen Degradation Products / analysis
Humans
Hypersplenism / complications,  surgery*
Infusions, Intravenous
Laparoscopy
Liver Cirrhosis / blood,  complications*
Male
Middle Aged
Portal Vein*
Postoperative Care
Preoperative Care
Risk Factors
Splenectomy / adverse effects*
Tomography, X-Ray Computed
Ultrasonography, Doppler
Venous Thrombosis / diagnosis,  drug therapy,  etiology,  prevention & control*
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Fibrin Fibrinogen Degradation Products; 0/fibrin fragment D; 9000-94-6/Antithrombin III

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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