title: Administration of antithrombin III attenuates posthepatectomy liver failure in hepatocellular carcinoma.
abstract: OBJECTIVE
  Coagulopathy can cause disseminated intravascular coagulation and posthepatectomy liver failure. Posthepatectomy liver failure predicts a poor prognosis after hepatectomy for hepatocellular carcinoma. Although antithrombin III reduces hypercoagulation, the impact of postoperative antithrombin III administration remains unknown. The aim of this study was to determine whether postoperative antithrombin III administration protects against the development of coagulation disorders.
  
  
  METHODS
  Data from 164 patients who received antithrombin III and 169 who did following curative hepatectomy for hepatocellular carcinoma were retrospectively collected and analyzed. To overcome bias due to different distributions of covariates for the two groups, a one-to-one match was created using propensity score analysis. After matching, patient outcomes were analyzed.
  
  
  RESULTS
  A multivariate analysis of the whole group revealed that antithrombin III activity of <50% on postoperative day 1 was an independent risk factor for posthepatectomy liver failure. After one-to-one matching, the rate of posthepatectomy liver failure was significantly lower in the AT-III-treated group than in the non-AT-III-treated group (16.3% (7/43) vs. 44.2% (19/43), p < 0.01).
  
  
  CONCLUSIONS
  Antithrombin III may attenuate posthepatectomy liver failure in hepatocellular carcinoma, possibly by suppressing coagulopathy.
authors.affiliation: Department of Gastroenterological and Transplant Surgery, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Kuroda
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Tashiro
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Masakazu
authors.initials: M
authors.lastname: Hashimoto
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Mikuriya
authors.forename: Hideki
authors.initials: H
authors.lastname: Ohdan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000990:Antithrombin III / Q000627:therapeutic use*; D000991:Antithrombins / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D004334:Drug Administration Schedule; D005260:Female; D006498:Hepatectomy; D006801:Humans; D017093:Liver Failure / Q000209:etiology / Q000517:prevention & control*; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control*; D057216:Propensity Score; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000991:Antithrombins; D000990:Antithrombin III