title: Four cases of cardiopulmonary thromboembolism during liver transplantation without the use of antifibrinolytic drugs.
abstract: Orthotopic liver transplantation (OLT) is one of the most demanding surgical procedures performed. Intraoperative bleeding can be substantial and related to both surgical and nonsurgical causes. A less common but previously reported phenomenon is intraoperative cardiopulmonary thromboembolism precipitating major patient morbidity and mortality. In this paper, we present four cases of intraoperative thromboembolism during OLT. These cases were performed without the concomitant use of antifibrinolytic drugs. We performed a review and analysis of previously reported cases of intraoperative thromboembolism during OLT. Possible causes of thromboembolism, clinical management, use of thromboelastography, and the role of antifibrinolytic drugs are discussed.
authors.affiliation: Departments of Anesthesiology and Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Adam B
authors.initials: AB
authors.lastname: Lerner
authors.forename: Eswar
authors.initials: E
authors.lastname: Sundar
authors.forename: Feroze
authors.initials: F
authors.lastname: Mahmood
authors.forename: Todd
authors.initials: T
authors.lastname: Sarge
authors.forename: Douglas W
authors.initials: DW
authors.lastname: Hanto
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Panzica
mesh_terms: D000328:Adult; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D003328:Coronary Thrombosis / Q000209:etiology*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000209:etiology*
chemical_list: D000933:Antifibrinolytic Agents