Liver Transplantation for Prothrombin Deficiency Causing Life-Threatening Bleeds.
Bibliographic record
Abstract
Abstract We report here the first case of living-related liver transplantation to correct a severe bleeding diathesis. A Caucasian infant was diagnosed at 11 weeks old with prothrombin deficiency after a spontaneous subdural hemorrhage. Even though he had a Factor II activity level of 0.08, he had severe clinical complications including umbilical bleeding, hemorrhagic shock after circumcision and bleeding per rectum. Prophylactic treatment with prothrombin complex concentrate prevented further bleeding episodes. Unfortunately, he developed clots of the superior vena cava and of the inferior vena cava in the context of central venous catheters. On-demand therapy via peripheral IV was followed for almost a year. He then had severe subdural and intraparenchymal hemorrhages. His clinical course did not correlate with measured Factor II activity. Investigations looking for other coagulation disorders were negative. He underwent a living-related liver transplant from his father in order to correct the bleeding diathesis. After transplant his Factor II level rose to 0.51. He required a second liver transplant (cadaveric) and died from tranplant related complications within a month. Management decisions must reflect the clinical severity of bleeding and not the activity level in rare bleeding disorders where no treatment guidelines exist.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".