title: Chemoprophylaxis Use and Risk of Venous Thromboembolism and Death in Adult Patients following Orthotopic Liver Transplantation.
abstract: BACKGROUND
  Coagulation abnormalities in end-stage liver disease may preclude patients from receiving venous thromboembolism (VTE) prophylaxis immediately following orthotopic liver transplantation.
  
  
  METHODS
  To identify risk factors for VTE and death following liver transplantation, a retrospective chart review was conducted in adult liver transplant recipients from January 1, 2001, to October 1, 2011.
  
  
  RESULTS
  In 716 transplantations in 701 patients, the overall incidence of VTE was 2.1%. The incidence was 3.6% in patients who received chemoprophylaxis compared to 1.4% in those without chemoprophylaxis (P = .06). Most patients (69.5%) did not receive chemoprophylaxis postsurgery during their hospitalization. Multivariate logistic regression modeling revealed no association between the use of chemoprophylaxis (adjusted odds ratio [OR] 1.5 [0.45-4.7], P = .53) and VTE. A significant positive association was observed between the use of chemoprophylaxis (adjusted OR 3.2 [1.3-8.0], P = .01) and death.
  
  
  CONCLUSIONS
  Use of chemoprophylaxis and increasing amounts of blood products following orthotopic liver transplant was associated with increased mortality. A significant positive association was observed between blood product administration and VTE, while chemoprophylaxis use was not significantly associated with VTE. Larger prospective studies are necessary to further examine the significance of this finding.
authors.affiliation: Department of Pharmacy, Duke University Hospital, Durham, NC, USA brianna.franklin@dm.duke.edu.
authors.forename: Brianna R
authors.initials: BR
authors.lastname: Alexander
authors.affiliation: Department of Pharmacy, University of Florida Health Shands Hospital, Gainesville, FL, USA.
authors.forename: Abigail D
authors.initials: AD
authors.lastname: Antigua
authors.affiliation: Department of Pharmacy, University of Florida Health Shands Hospital, Gainesville, FL, USA.
authors.forename: Amy F
authors.initials: AF
authors.lastname: Rosenberg
authors.affiliation: Department of Anesthesiology, Division of Critical Care Medicine, University of Florida, Gainesville, FL, USA.
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Caruso
authors.affiliation: Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, FL, USA.
authors.forename: Stacy A
authors.initials: SA
authors.lastname: Voils
authors.affiliation: Department of Pharmacy, University of Florida Health Shands Hospital, Gainesville, FL, USA.
authors.forename: Aimée C
authors.initials: AC
authors.lastname: LeClaire
mesh_terms: D000328:Adult; D000368:Aged; D018890:Chemoprevention / Q000009:adverse effects* / Q000401:mortality; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D012189:Retrospective Studies; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000139:chemically induced* / Q000175:diagnosis / Q000401:mortality*
keywords: anticoagulation; enoxaparin; liver transplantation; unfractionated heparin; venous thromboembolism