Vitamin K therapy in severe liver disease

A middle-aged man with parenchymatous liver disease and a decrease in vitamin K-dependent factors was given large doses of intravenous phylloquinone (10 mg/d for 20 days) without improvement in the synthesis of vitamin K-dependent factors. During subsequent liver transplantation, he exsanguinated. Although the exact role of over treatment with phylloquinone in this case is unclear, plasma levels of phylloquinone 300 times normal were attained after 5 days of treatment without effect on factors II, VII, IX, and X. Further therapy with vitamin K was unnecessary.