Anticoagulation with hirudin for continuous veno-venous hemodialysis in liver transplantation.
Postoperative encephalopathy after orthotopic liver transplantation can be difficult to diagnose. We report a case of heparin-induced thrombocytopenia in a liver transplant patient who had seizures. Due to poor liver function the patient developed hepatorenal syndrome requiring continuous veno-venous hemodialysis (CVVHD). Initially we used heparin as the anticoagulant. After the diagnosis of heparin-induced thrombocytopenia (HIT) was made, we switched to r-hirudin. No serious side effects, e.g. bleeding or immune sensitization, were seen.
Saner
F
F
Department of General and Transplantation Surgery, University Hospital Essen, Germany. fuat.saner@uni-essen.de
Hertl
M
M
Broelsch
C E
CE
D000328:Adult; D017809:Fatal Outcome; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006440:Hemofiltration; D019693:Hepatitis, Autoimmune / Q000601:surgery; D024764:Hirudin Therapy; D006629:Hirudins / Q000009:adverse effects; D006801:Humans; D008102:Liver Circulation / Q000502:physiology; D016031:Liver Transplantation / Q000502:physiology*; D008297:Male; D010314:Partial Thromboplastin Time; D011517:Prothrombin Time
D005343:Fibrinolytic Agents; D006629:Hirudins