RT Journal
A1 Kahn D, Krige JE
T1 Adamts13: Comment on “increased von willebrand factor to adamts13 ratio as a predictor of thrombotic complications following a major hepatectomy”
JF Archives of Surgery
JO Archives of Surgery
YR 2012
FD October 1
VO 147
IS 10
SP 917
OP 918
DO 10.1001/archsurg.2012.1231
UL http://dx.doi.org/10.1001/archsurg.2012.1231
AB 
The role of ADAMTS13 (a disintegrin and metalloprotease with a thrombospondin type 1 motif, member 13) in hemostasis has been extensively documented in the hematology literature. In contrast, ADAMTS13 has hardly been noticed on the surgical radar. ADAMTS13 is a specific metalloproteinase that is responsible for cleaving the multimeric form of von Willebrand factor, thus preventing platelet aggregation and thrombus formation.1 Conversely, in the absence of ADAMTS13 activity, or with a profound deficiency of ADAMTS13, due to either genetic mutations or autoimmune inhibitors, ultralarge von Willebrand factor produced by vascular endothelial cells accumulate and induce widespread microvascular thrombosis characteristic of thrombotic thrombocytopenic purpura.