Abstract
A 59-year-old woman was referred to our hospital for treatment of a hepatic mass. She had a history of repeated nosebleeds at a young age, and had received blood transfusions several times. She had been given a diagnosis of chronic hepatitis C by a local physician 9 years previously. On admission, the activated partial thromboplastin time (APTT) was slightly prolonged, and the bleeding time was prolonged. On further examination, the von Willebrand factor (<6%) and factor VIII (52%) levels were found to be decreasing. Hepatocellular carcinoma was diagnosed, and her bleeding tendency was thought to be due to von Willebrand disease. According to the guidelines for coagulation factor replacement therapy, using the APTT as an index, we administered blood clotting factor VIII/von Willebrand factor concentrate for 8 days before and after surgery, and successfully maintained the APTT. The patient’s postoperative course was uneventful. In this case, we successfully and safely performed hepatectomy in a patient with von Willebrand disease by supplying factor VIII/von Willebrand factor concentrate.
