Protein C activity and postoperative metabolic liver function after liver transplantation

G. Wagener, G. Diaz, J. V. Guarrera, M. Minhaz, J. F. Renz, R. N. Sladen

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background. Protein C is a natural thrombin antagonist produced by hepatocytes. Its levels are low in liver failure and predispose patients to increased risk for thrombosis. Little is known about the relationship between protein C activity and hepatic function after orthotopic liver transplantation (OLT). Methods. We measured protein C activity of 41 patients undergoing liver transplantation by the Staclot method (normal range, 70%-130%) preoperatively and then daily on postoperative days (POD) 0-5. Results. The mean protein C activity was low before OLT (34.3 ± 4.3%) and inversely correlated with the preoperative Model for End-Stage Liver Disease score (Spearman's r = -0.643; P < .0001). Mean activity increased significantly on POD 1 (58.9 ± 4.5%), and remained above preoperative levels through POD 5. Ten patients developed metabolic liver dysfunction defined by a serum total bilirubin >5 mg/dL on POD 7. These patients had significantly lower protein C activity from POD 3 (47.2 ± 9.6% vs 75.9 ± 5.8%; P = .01) to POD 5. Preoperative protein C activity correlated inversely with the severity of liver failure as indicated by preoperative MELD score. Conclusion. Protein C activity recovered rapidly in patients with good allograft function but remained significantly lower in patients who had limited metabolic function as evidenced by increased total bilirubin levels.

Original languageEnglish (US)
Pages (from-to)1336-1340
Number of pages5
JournalTransplantation Proceedings
Issue number5
StatePublished - Jun 2012
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Transplantation


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