Abstract
Introduction. Recent studies have indicated an increased incidence of thrombotic vascular complications after liver transplantation. The reasons may be associated with surgical technique and “unbalanced” hemostasis in patients with diffuse liver diseases. The imbalance is determined by the deficiency of physiological procoagulants and anticoagulants due to a reduced protein-synthesis function of the liver in chronic hepatocyte injury. At the same time, 90% of all spontaneous antithrombin activity is associated with antithrombin III.Aim. The aim of the study was to evaluate the efficacy of using antithrombin III concentrate in liver transplant patients.Material and methods. A retrospective study included 46 patients undergoing liver transplantation who had nonocclusive thrombosis in the portal vein system prior to surgery and postoperative venous or arterial thrombosis.Results. The treatment results were compared between the group with antithrombin III concentrate and the control group in patients with portal vein thrombosis before surgery and postoperative venous or arterial thrombosis; the antithrombin III activity dynamics in the early postoperative period was assessed; the incidence of infectious, and vascular complications and the mortality rates were analyzed.Conclusion. The antithrombin III concentrate administration during liver transplantation and in the postoperative period contributes to a rapid normalization of antithrombin III activity in blood, the decrease in mortality and in the incidence of infectious and thrombotic complication rates.
Highlights
90% of all spontaneous antithrombin activity is associated with antithrombin III
The aim of the study was to evaluate the efficacy of using antithrombin III concentrate in liver transplant patients
The treatment results were compared between the group with antithrombin III concentrate and the control group in patients with portal vein thrombosis before surgery and postoperative venous or arterial thrombosis; the antithrombin III activity dynamics in the early postoperative period was assessed; the incidence of infectious, and vascular complications and the mortality rates were analyzed
Summary
Исследования последних лет указывают на рост частоты тромботических сосудистых осложнений после трансплантации печени. Цель исследования состояла в оценке эффективности использования концентрата антитромбина III у пациентов, подвергшихся трансплантации печени. В ретроспективное исследование включены 46 пациентов с неокклюзионным тромбозом в системе воротной вены до операции и послеоперационными венозными или артериальными тромбозами, которым была выполнена трансплантация печени. Сравнили результаты лечения в группе больных, получавших концентрат антитромбина III, и в группе сравнения, где антитромбин III не использовался, у пациентов с тромбозом воротной вены до операции и послеоперационными венозными или артериальными тромбозами, оценили динамику активности антитромбина III в раннем послеоперационном периоде, частоту инфекционных, сосудистых осложнений и летальности. Назначение концентрата антитромбина III во время трансплантации печени и в раннем послеоперационном периоде приводит к быстрой нормализации активности антитромбина III в крови, снижению летальности и частоты инфекционных и тромботических осложнений. Ключевые слова: трансплантация печени, тромбоз воротной вены, тромбоз печеночной артерии, антитромбин III, антикоагулянтная терапия
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