title: Efficacy of recombinant thrombomodulin for DIC after deceased donor liver transplantation: a case report.
abstract: BACKGROUND
  Disseminated intravascular coagulation (DIC) after liver transplantation (LT) is a difficult complication. We report a case of disseminated intravascular coagulation after deceased donor liver transplantation (DDLT) treated with recombinant thrombomodulin (rTM).
  
  
  METHODS
  A 30-year-old woman underwent right tri-segment split graft DDLT for acute liver failure. She developed disseminated intravascular coagulation on post-operative day 5 with fever. Computed tomography revealed necrosis of hepatic segment IV, and her acute-phase disseminated intravascular coagulation score was seven points. She was given rTM, and the inflammation, liver function, and coagulation disorders immediately improved. However, pleural effusion drainage from the chest tube became bloody on post-operative day 11, and rTM was discontinued. She progressed well and was discharged from the hospital on post-operative day 28. rTM is an effective treatment for disseminated intravascular coagulation; however, rTM for cases with coagulation disorders, which can occur after liver transplantation, has both risks and benefits.
  
  
  CONCLUSIONS
  We report a case of DIC after LT, in which rTM was potentially effective. Further studies are needed to determine the appropriate dosages, duration, and additional considerations for rTM therapy in liver transplantation patients.
authors: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan. cubicseal@gmail.com.
authors: Koichi
authors: K
authors: Kimura
authors: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan.
authors: Tomoharu
authors: T
authors: Yoshizumi
authors: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan.
authors: Shinji
authors: S
authors: Itoh
authors: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan.
authors: Norifumi
authors: N
authors: Harimoto
authors: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan.
authors: Takashi
authors: T
authors: Motomura
authors: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan.
authors: Noboru
authors: N
authors: Harada
authors: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan.
authors: Akihisa
authors: A
authors: Nagatsu
authors: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan.
authors: Toru
authors: T
authors: Ikegami
authors: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan.
authors: Mizuki
authors: M
authors: Ninomiya
authors: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan.
authors: Yuji
authors: Y
authors: Soejima
authors: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan.
authors: Yoshihiko
authors: Y
authors: Maehara
keywords: Deceased donor liver transplantation; Disseminated intravascular coagulation; Recombinant thrombomodulin; Split graft