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Updated: Apr 15, 2026

Application of Hemostatic Devices in Laparoscopic Hepatectomy
Published on: April 19, 2022
Administration of antithrombin III attenuates posthepatectomy liver failure in hepatocellular carcinoma
Shintaro Kuroda1, Hirotaka Tashiro, Tsuyoshi Kobayashi
1Department of Gastroenterological and Transplant Surgery, Hiroshima University Hospital, Hiroshima, Japan.
Background/Aims:
Coagulopathy can cause disseminated intravascular coagulation and posthepatectomy liver failure. Posthepatectomy liver failure predicts a poor prognosis after hepatectomy for hepatocellular carcinoma. Although antithrombin III reduces hypercoagulation, the impact of postoperative antithrombin III administration remains unknown. The aim of this study was to determine whether postoperative antithrombin III administration protects against the development of coagulation disorders.
Methods:
Data from 164 patients who received antithrombin III and 169 who did following curative hepatectomy for hepatocellular carcinoma were retrospectively collected and analyzed. To overcome bias due to different distributions of covariates for the two groups, a one-to-one match was created using propensity score analysis. After matching, patient outcomes were analyzed.
Results:
A multivariate analysis of the whole group revealed that antithrombin III activity of <50% on postoperative day 1 was an independent risk factor for posthepatectomy liver failure. After one-to-one matching, the rate of posthepatectomy liver failure was significantly lower in the AT-III-treated group than in the non-AT-III-treated group (16.3% (7/43) vs. 44.2% (19/43), p < 0.01).
Conclusions:
Antithrombin III may attenuate posthepatectomy liver failure in hepatocellular carcinoma, possibly by suppressing coagulopathy.
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