PMC5910518_01
CT arterial portography (CTAP)/CT hepatic arteriography (CTHA) image.. CTAP revealed both S5 (a) and S1 (c) tumors with perfusion defects. CTHA revealed both S5 (b) and S1 (d) tumors with enhanced image (yellow arrow).
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Both tumors were revealed defection with CTAP, and enhancement with CTHA, which were typical findings of HCC (Fig. 1).
Serial change in APTT by supplying FVIII/VWF concentrate.. We administered VWF:Rco at a dose of 3200 IU just before surgery and 1600 IU after surgery. Although the APTT was temporarily prolonged to 48.5 s 3 h after the start of surgery, we could confirm an improvement in the APTT value. The APTT was successfully maintained at 35.9-40.2 s after surgery.
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We administered FVIII/VWF concentrate (Confact F ; Chemo-Sero-Therapeutic Research Institute, Kumamoto, Japan), plasma-derived product, not be distributed in the world, at a dose of 3200 IU of VWF:RCo before surgery and at a dose of 1600 IU of VWF:RCo just after surgery (Fig. 2). APTT as indexes of the activation of intrinsic coagulation and the activation of VWF. Although APTT was temporarily prolonged to 48.5 s 3 h after the start of surgery (Fig. 2), we could successfully maintain the APTT while administering the FVIII/VWF concentrate during and after the operation.
Activity of factor VIII (FVIII), von Willebrand factor antigen (VWF:Ag), and von Willebrand factor activity (VWF:RCo) during the perioperative period.. We could confirm that the highest activity level of FVIII increased to 200%, that of VWF:Ag to 265%, and that of VWF:RCo to 130%. The postoperative activity of FVIII, VWF:Ag, and VWF:RCo increased and peaked on the first postoperative day, and the infusion of FVIII/VWF concentrate was stopped; activity levels dropped continuously until discharge on day 12.
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The postoperative activities of FVIII, VWF:Ag, and VWF:RCo increased and peaked on the first postoperative day, and the infusion of FVIII/VWF concentrate was stopped; activity levels dropped continuously until discharge on day 12 (Fig. 3).