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Eur J Gastroenterol Hepatol. 1995 Feb;7(2):155-9.

Fibrinolytic abnormalities following liver transplantation in patients with fulminant hepatic failure.

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  • 1Institute of Liver Studies, King's College Hospital, London, UK.

Abstract

OBJECTIVE:

To evaluate the fibrinolytic system after liver transplantation in patients with fulminant hepatic failure.

DESIGN:

Seven patients were studied prior to, and for 4 days after, liver transplantation.

METHODS:

Both activators and inhibitors of the fibrinolytic system were investigated in seven patients with fulminant hepatic failure who underwent liver transplantation.

RESULTS:

alpha 2-antiplasmin and C1-inhibitor levels increased rapidly after transplantation (81 and 53% of normal on day 1; 106 and 99% on day 2, respectively). Plasminogen levels remained low throughout the 4-day study period. Plasminogen activator inhibitor-1 was higher than normal before transplantation (21.0 compared with 7.4 U/ml) and increased further on the first day after operation (37.5 U/ml; P < 0.05 versus pre-transplantation). Tissue plasminogen activator levels remained normal (pre-operative, 7.0 IU/ml; Day 4, 0.2 IU/ml). D-dimer remained elevated during the postoperative period showing increased fibrinolytic activity. Thrombin-antithrombin III complex was also elevated during the study period. Antithrombin III was greatly reduced prior to transplantation (13.7% of normal) and plasma levels were less than 50% of normal values during the study.

CONCLUSIONS:

Measures of fibrinolytic activity are raised after liver transplantation in patients with fulminant hepatic failure. This is probably due to increased fibrin formation caused by a coexisting hypercoagulable state.

PMID:
7536112
[PubMed - indexed for MEDLINE]
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