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Do postliver transplant patients need thromboprophylactic anticoagulation?

Amar Nath Mukerji1, Andreas Karachristos1, Manoj Maloo1

  • 1Department of Surgery, Division of Abdominal Organ Transplant, Liver Transplant Program, Temple University Hospital, Philadelphia, PA, USA.

Clinical and Applied Thrombosis/Hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
|June 12, 2014
PubMed

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.

Keywords:
anticoagulantsdeep venous thrombosisthrombosis prophylaxisvenous thromboembolism

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