Two cases of central venous catheter-related thrombosis in living liver donors: how can the risk be minimized?
A central venous catheter (CVC) is commonly used for intraoperative management by anesthetists and surgeons during major operations, including donor operations for living donor liver transplantation (LDLT), in which donor safety is of utmost importance. Reasons for use of CVC for donors include measurement of central venous pressure and drug infusion when necessary. A potentially serious complication of a major operation is pulmonary thromboembolism. We report two cases of LDLT donors complicated by catheter related thrombosis (CRT) of the jugular vein, who were eventually discharged without long-term complications. To the best of our knowledge, there has been no report of CRT among LDLT donor population. In this report, in order to minimize the risks related to CRT in LDLT donors, we propose thorough screening for thrombophilic disorders, use of a silicone or polyurethane double-lumen CVC as thin as possible, placement of the tip of the CVC at the superior vena cava via the right jugular vein using ultrasonography as a guide for puncture, and removal of the catheter at the end of the operation based on our experience of CRT among LDLT donors.
Hata
Taigo
T
Department of Transplantation Surgery, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
Fujimoto
Yasuhiro
Y
Suzuki
Kojiro
K
Kim
Byeoknyeon
B
Ishigami
Masatoshi
M
Ogawa
Hayato
H
Arikawa
Takashi
T
Nagai
Shunji
S
Kamei
Hideya
H
Nakamura
Taro
T
Edamoto
Yoshihiro
Y
Kiuchi
Tetsuya
T
D002405:Catheterization, Central Venous; D005260:Female; D006801:Humans; D007601:Jugular Veins / Q000601:surgery; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013927:Thrombosis / Q000209:etiology* / Q000473:pathology