PREVENTION OF POSTOPERATIVE THROMBOEMBOLIC COMPLICATIONS IN A PATIENTWITH BUDD-CHIARI SYNDROME AND ACQUIRED PROTEIN-C DEFICIENCY BY SHORT-TERM ADMINISTRATION OF PROTEIN-C CONCENTRATES

Protein C and its associated cofactor protein S are vitamin K-dependen t anticoagulative plasma proteins, that regulate coagulation by inhibi ting activated cofactors Va and VIIIa and by stimulating fibrinolysis or inhibition of clot formation, Primary synthesis in the liver may re sult in a secondary deficiency in patients with impaired liver functio n, leading to thromboembolic complications, We report a case of Budd-C hiari syndrome, complicated by portal vein thrombosis and incomplete t hrombosis of the inferior vena cava, resulting from an acquired protei n C deficiency, Effective treatment was achieved by portacaval shuntin g, supplied by postsurgical substitution of protein C concentrates, Pr otein C levels raised according to recovering liver function and showe d a normal ratio compared with prothrombin time under warfarin therapy , Routine monitoring of proteins C and S should be taken into consider ation in all cases of impaired liver synthesis, Acquired protein C def iciency resulting from severe liver disease can effectively be treated by administration of highly purified protein C concentrates.