Massive Fulminant Thrombosis During Liver Transplantation in a Patient With a Previously Unknown Antithrombin Pathway Mutation

Dmitri Bezinover, Shigekazu Sugino, Yuka Imamura-Kawasawa, Matthew S. Bell, Zakiyah Kadry, Piotr K. Janicki

Research output: Contribution to journalArticlepeer-review

Abstract

We describe a case of fulminant intraoperative thrombosis during deceased donor liver transplantation. Despite significant medical bleeding, the patient suddenly developed diffuse thrombosis in all chambers of the heart and pulmonary vasculature resulting in intraoperative death. The patient's postmortem genetic analysis demonstrated a deleterious missense mutation in a coagulation pathway gene, SERPINC1, which codes for antithrombin III. The level of antithrombin III was not available to directly prove the causality of thrombosis, but our findings suggest that this mutation, in combination with antifibrinolytic administration in a hypercoagulable cirrhotic patient, might have contributed to the development of this catastrophic thrombotic event.

Original languageEnglish
Pages (from-to)239-242
Number of pages4
JournalA & A case reports
Volume7
Issue number11
DOIs
Publication statusPublished - 2016 Dec 1

ASJC Scopus subject areas

  • Medicine(all)

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