Related Experiment Video
Updated: May 20, 2026
New Thrombectomy Technique for Total Portal Vein Thrombosis in Liver Transplantation
Published on: June 27, 2025
Successful liver transplantation with continued dual antiplatelet therapy
Henning Spieker1, Christoph Benckert, Markus Quante
1Department of Visceral, Transplantation, Thoracic and Vascular Surgery, University Hospital Leipzig, Germany. henning.spieker@medizin.uni-leipzig.de
Insights
Liver transplantation can be safely performed in patients on dual antiplatelet therapy (aspirin and clopidogrel). This approach avoids cardiac risks and major bleeding complications, offering a viable option for high-risk patients.
Area of Science:
- Hepatology
- Cardiology
- Transplantation Surgery
Background:
- Liver transplantation is a high-risk procedure for patients on dual antiplatelet therapy due to bleeding risks.
- Withdrawing antiplatelet therapy can precipitate major adverse cardiac events, including stent thrombosis and myocardial infarction.
Observation:
- A 61-year-old male with liver cirrhosis on aspirin and clopidogrel underwent liver transplantation.
- Dual antiplatelet therapy was continued throughout the transplantation procedure.
Findings:
- The liver transplantation was successful without discontinuing aspirin and clopidogrel.
- The patient experienced no cardiac events or significant bleeding complications post-procedure.
Implications:
- This case demonstrates the feasibility of performing liver transplantation under dual antiplatelet therapy.
- Careful risk assessment allows for safe management of high-risk surgical patients on essential cardiovascular medications.
Background:
Liver transplantation in patients with dual antiplatelet therapy is considered high-risk procedure due to possible bleeding complications. However, withdrawal of antiplatelet therapy can lead to major adverse cardiac events such as stent thrombosis and even fatal myocardial infarction.
Case Report:
We report on a 61-year-old male patient with nutritive toxic liver cirrhosis who underwent liver transplantation at our hospital in March 2010. Following two strokes he received secondary prophylaxis with aspirin and clopidogrel, which was continued at time of liver transplantation. The transplantation was performed successfully without withdrawal of the antiplatelet therapy. No cardiac event and no major bleeding complication occurred.
Conclusions:
This is, to our knowledge, the first report of a liver transplantation under dual antiplatelet therapy with aspirin and clopidogrel. It shows that even major procedures such as liver transplantation, with its associated high risk of surgical bleeding, can be safely performed with an appropriate risk.
