title: Donor intracaval thrombus formation and pulmonary embolism after simultaneous piggyback liver transplantation and aortic valve replacement.
abstract: Pulmonary embolism (PE) is a well known and serious complication that may develop after abdominal surgery. Liver transplant recipients are not immune to PE and tend to share many of the same risk factors with surgical patients who are stricken with this potential fatal complication. Liver transplantation using the piggyback (PB) technique is widely accepted, although there are reports of technique-specific-related vascular complications. We present a case of a 49-yr-old male liver transplant recipient who received his graft using the PB while simultaneously undergoing aortic valve replacement. His post-operative course was complicated by a PE 15 d after his surgery and was the result of an intracaval thrombus of the graft liver. The current case should alert clinicians to think of a donor intracaval thrombus as a complication of PB liver transplantation and a possible source of PE.
authors.affiliation: Division of Transplantation, Department of Surgery, University of Miami/Jackson Memorial Medical Center, Miami, FL, USA. snishida@med.miami.edu
authors.forename: Seigo
authors.initials: S
authors.lastname: Nishida
authors.forename: Anil
authors.initials: A
authors.lastname: Vaidya
authors.forename: Edson
authors.initials: E
authors.lastname: Franco
authors.forename: Guy
authors.initials: G
authors.lastname: Neff
authors.forename: Juan
authors.initials: J
authors.lastname: Madariaga
authors.forename: Noboru
authors.initials: N
authors.lastname: Nakamura
authors.forename: David M
authors.initials: DM
authors.lastname: Levi
authors.forename: Jose R
authors.initials: JR
authors.lastname: Nery
authors.forename: Hooshang
authors.initials: H
authors.lastname: Bolooki
authors.forename: Andreas G
authors.initials: AG
authors.lastname: Tzakis
mesh_terms: D001021:Aortic Valve / Q000601:surgery*; D001705:Bioprosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000209:etiology*; D014019:Tissue Donors; D014682:Vena Cava, Inferior / Q000637:transplantation; D020246:Venous Thrombosis / Q000150:complications*