title: Do postliver transplant patients need thromboprophylactic anticoagulation?
abstract: Postoperative thromboprophylactic anticoagulation against Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE) is standard of care with current evidence-based guidelines. However, majority of liver transplant (LT) patients have thrombocytopenia and/or prolonged INR before surgery. Studies or guidelines regarding role of prophylactic anticoagulation after LT are lacking. There is a need to balance the risk of thrombosis with significant hemorrhage, implying those needing transfusion or return to OR due to bleeding. We conclude that after LT, anticoagulation is not required routinely for DVT/PE prophylaxis. Rather, it is indicated in specific circumstances, chiefly for prophylaxis of hepatic artery thrombosis or portal vein thrombosis in cases with use of grafts, pediatric cases, small size vessels, Budd Chiari syndrome, amongst others.
authors.affiliation: Department of Surgery, Division of Abdominal Organ Transplant, Liver Transplant Program, Temple University Hospital, Philadelphia, PA, USA.
authors.forename: Amar Nath
authors.initials: AN
authors.lastname: Mukerji
authors.affiliation: Department of Surgery, Division of Abdominal Organ Transplant, Liver Transplant Program, Temple University Hospital, Philadelphia, PA, USA.
authors.forename: Andreas
authors.initials: A
authors.lastname: Karachristos
authors.affiliation: Department of Surgery, Division of Abdominal Organ Transplant, Liver Transplant Program, Temple University Hospital, Philadelphia, PA, USA.
authors.forename: Manoj
authors.initials: M
authors.lastname: Maloo
authors.affiliation: Department of Pharmacy, Temple University Hospital, Philadelphia, PA, USA.
authors.forename: David
authors.initials: D
authors.lastname: Johnson
authors.affiliation: Department of Surgery, Division of Abdominal Organ Transplant, Liver Transplant Program, Temple University Hospital, Philadelphia, PA, USA ashokkumar.jain@tuhs.temple.edu.
authors.forename: Ashokkumar
authors.initials: A
authors.lastname: Jain
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D006502:Budd-Chiari Syndrome / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D019934:International Normalized Ratio; D016031:Liver Transplantation / Q000009:adverse effects*; D011183:Postoperative Complications / Q000517:prevention & control*; D011655:Pulmonary Embolism / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants
keywords: anticoagulants; deep venous thrombosis; thrombosis prophylaxis; venous thromboembolism