Valerie Emuakhagbon1, Prejesh Philips2, Vatche Agopian3, Fady M Kaldas3, Christopher M Jones4. 1. Division of Transplant Surgery, Department of Surgery, University of Louisville School of Medicine, 550 South Jackson Street, Louisville, KY, 40202, USA. 2. Division of Surgical Oncology, Department of Surgery, University of Louisville School of Medicine, Louisville, KY, USA. 3. Division of Liver and Pancreas Transplant Surgery, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. 4. Division of Transplant Surgery, Department of Surgery, University of Louisville School of Medicine, 550 South Jackson Street, Louisville, KY, 40202, USA. Electronic address: Christopher.jones.1@louisville.edu.
Abstract
BACKGROUND: Omitting chemical venous thromboembolism prophylaxis in liver transplant recipients may lead to an increase incidence of deep venous thrombosis (DVT) and/or pulmonary embolus (PE). METHODS: A retrospective comparison of liver transplant recipients who developed postoperative DVT/PE to an age-matched population. RESULTS: Forty-three of eight hundred sixty-seven patients developed a DVT/PE. Study group patients received higher amounts of cryoprecipitate and fresh frozen plasma. Study group international normalized ratio (INR) was significantly higher, as was the incidence of postoperative complications. High-grade complication rates (bleeding, respiratory failure, and renal insufficiency) were increased in the study group at 16% vs 0%. CONCLUSIONS: The present study demonstrates that the rate of DVT/PE after liver transplantation is similar to the rate after other major operations. Patients were more likely to develop DVT/PE if they received increased amounts of intraoperative cryoprecipitate/fresh frozen plasma (FFP) or had an elevated postoperative INR. Furthermore, patients with a complicated postoperative course have the highest risk of venous thromboembolism.
BACKGROUND: Omitting chemical venous thromboembolism prophylaxis in liver transplant recipients may lead to an increase incidence of deep venous thrombosis (DVT) and/or pulmonary embolus (PE). METHODS: A retrospective comparison of liver transplant recipients who developed postoperative DVT/PE to an age-matched population. RESULTS: Forty-three of eight hundred sixty-seven patients developed a DVT/PE. Study group patients received higher amounts of cryoprecipitate and fresh frozen plasma. Study group international normalized ratio (INR) was significantly higher, as was the incidence of postoperative complications. High-grade complication rates (bleeding, respiratory failure, and renal insufficiency) were increased in the study group at 16% vs 0%. CONCLUSIONS: The present study demonstrates that the rate of DVT/PE after liver transplantation is similar to the rate after other major operations. Patients were more likely to develop DVT/PE if they received increased amounts of intraoperative cryoprecipitate/fresh frozen plasma (FFP) or had an elevated postoperative INR. Furthermore, patients with a complicated postoperative course have the highest risk of venous thromboembolism.