Abstract
Fibrin degradation products, D-dimer (FDP-DD), and soluble fibrin (SF) are useful markers for the diagnosis of thrombosis. Among them, SF is relatively new, so the dynamics of SF during thrombolytic therapy for portal vein thrombosis (PVT) have not been well known.
A 9-month-old girl underwent living-donor liver transplantation at her 7 months as a result of biliary cirrhosis after Kasai's procedure. The clinical course after transplantation was uneventful, and she was discharged on postoperative day 42. Six days after discharge, because of cholangitis with high fever, she entered our hospital, and ultrasound revealed PVT in the umbilical portion. At the time of diagnosis, the values of SF and FDP-DD were 12.5μg/ml, and 11.9μg/ml respectively. Five days after the initiation of thrombolytic therapy, PVT had disappeared. The value of SF was below the measurement sensitivity, but that of FDP-DD was 9.6μg/ml. The FDP-DD value fell to normal 27 days after the initiation of thrombolytic therapy. She now shows no signs of recurrence of PVT after an 11-month follow-up.
Imaging study and measurement of FDP-DD are essential to diagnose PVT. Because this case shows the possibility of SF as a useful surrogate maker to estimate thrombosis and thrombolysis in PVT after LT, further investigation is expected.
