Intravascular thrombosis and thromboembolism during liver transplantation: antifibrinolytic therapy implicated?
This case report describes a patient who underwent orthotopic liver transplantation and developed extensive hyperacute venous and arterial intravascular thromboses and thromboemboli intraoperatively. The patient was receiving antifibrinolytic therapy with aprotinin. The safety of routine aprotinin therapy in liver transplantation is examined. The value of the thrombelastograph (TEG) as a qualitative assessment of the coagulation system is emphasized.
Ramsay
Michael A E
MA
Department of Anesthesiology and Pain Management, Baylor Regional Transplant Institute, Baylor University Medical Center, Dallas, TX 75246, USA. docram@baylorhealth.edu
Randall
Henry B
HB
Burton
Elizabeth C
EC
D000328:Adult; D000933:Antifibrinolytic Agents / Q000009:adverse effects*; D007611:Aprotinin / Q000009:adverse effects*; D017809:Fatal Outcome; D006801:Humans; D007431:Intraoperative Complications; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D013923:Thromboembolism / Q000209:etiology* / Q000473:pathology; D013927:Thrombosis / Q000209:etiology* / Q000473:pathology
D000933:Antifibrinolytic Agents; D007611:Aprotinin