title: Venous Thrombotic Events After Liver Transplantation.
abstract: Thromboprophylaxis is not well defined after liver transplantation (LT). The aim of this study was to evaluate the incidence of splanchnic vein thrombosis (SVT) and nonsplanchnic vein thrombosis (NSVT) after LT. Liver transplantations performed between 2009 and 2013 in our institution were reviewed. Demographic, intraoperative, and postoperative data were recorded. Low-molecular-weight heparin was only administered postoperatively if intraoperative thrombectomy was performed or in patients preoperatively anticoagulated. Of a total of 328 patients, 72% were male with a median age of 56 years, score of model for end-stage liver disease 18 (11-23), and 88% had liver cirrhosis. The incidence of postoperative venous thrombotic events was 4.6%: 8 (2.4%) patients had SVT and 7 (2.1%) patients had NSVT. After logistic regression analysis, intraoperative thrombectomy and Child A classification emerged as risk factors for SVT (odds ratio [OR]: 77, 95% confidence interval [95% CI]: 14-421) and NSVT (OR: 20, 95% CI: 3-170), respectively. The incidence of SVT in patients who undergo intraoperative thrombectomy was 33%, whereas the incidence of NSVT in patients grouped as Child A was 7.5%. Our results suggest that thromboprophylaxis should be considered after LT in patients with cirrhosis grouped as Child A and in patients who undergo intraoperative thrombectomy.
authors.affiliation: 1 Anesthesia Department, Hospital Clinic de Barcelona, Barcelona, Spain.
authors.forename: Annabel
authors.initials: A
authors.lastname: Blasi
authors.affiliation: 2 Hepatic Hemodynamic Laboratory, Hospital Clinic de Barcelona, Barcelona, Spain.
authors.forename: Virginia
authors.initials: V
authors.lastname: Hernandez
authors.affiliation: 3 Hepatology Department, Hospital Clinic de Barcelona, Barcelona, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Fernandez
authors.affiliation: 3 Hepatology Department, Hospital Clinic de Barcelona, Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Colmenero
authors.affiliation: 1 Anesthesia Department, Hospital Clinic de Barcelona, Barcelona, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Beltran
authors.affiliation: 4 Surgery Department, Hospital Clinic de Barcelona, Barcelona, Spain.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Garcia-Valdecasas
authors.affiliation: 5 Hemotherapy Hemostasis Department, Hospital Clinic de Barcelona, Barcelona, Spain.
authors.forename: Joan Carles
authors.initials: JC
authors.lastname: Reverter
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D008103:Liver Cirrhosis / Q000150:complications; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D012189:Retrospective Studies; D012307:Risk Factors; D013152:Splanchnic Circulation; D017131:Thrombectomy; D020246:Venous Thrombosis / Q000209:etiology*
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight
keywords: deep venous thrombosis; thrombosis; thrombosis prophylaxis; venous thromboembolism