Related Experiment Video
Updated: Oct 5, 2025
Porcine Liver Transplantation Without Veno-Venous Bypass As an Extended Criteria Donor Model
Published on: August 17, 2022
Perioperative cangrelor in patients with recent percutaneous coronary intervention undergoing liver transplantation:
Luma Succar1, Chelsea N Lopez1, David W Victor2,3
1Department of Pharmacy, Houston Methodist Hospital, Houston, Texas, USA.
Insights
Cangrelor bridge therapy safely managed dual antiplatelet therapy (DAPT) in liver transplant patients with recent drug-eluting stents. This approach allowed successful post-operative return to oral DAPT without complications.
Area of Science:
- Cardiology
- Transplantation Medicine
- Pharmacology
Background:
- Perioperative dual antiplatelet therapy (DAPT) management is complex, especially for patients with coagulopathy or recent coronary stenting.
- Liver transplant recipients often present with complex medical histories requiring careful antiplatelet management.
Purpose of the Study:
- To evaluate the safety and efficacy of cangrelor bridge therapy in liver transplant patients requiring DAPT after coronary drug-eluting stent placement.
Main Methods:
- A case series describing two liver transplant patients who received cangrelor as a P2Y12 inhibitor bridge therapy.
- Cangrelor was administered at a dose of 0.75 μg/kg/min perioperatively.
Main Results:
- Cangrelor bridge therapy was safe and effective in both patients.
- Patients were successfully transitioned back to oral DAPT post-operatively.
- No additional bleeding or thrombotic complications occurred.
Conclusions:
- Cangrelor serves as a viable bridge therapy option for high-risk perioperative liver transplant patients requiring DAPT.
- This strategy facilitates continued P2Y12 inhibition during the perioperative period.
Background:
Management of dual antiplatelet therapy (DAPT) in the perioperative setting is challenging, particularly in complex patient populations, such as those with underlying coagulopathy and/or recent percutaneous coronary interventions.
Methods:
In this case series, we describe the perioperative use of cangrelor bridge therapy in two patients undergoing liver transplantation after recent coronary drug-eluting stent placement.
Outcomes:
In both patient cases, cangrelor use as a P2Y12 bridge at a dose of 0.75 μg/kg/min was safe and effective. Both patients were successfully switched back to their oral DAPT regimen post-operatively without additive bleeding or thrombotic complications.
Conclusion:
The use of cangrelor as bridge therapy in high-risk perioperative liver transplant patients appears to be a viable option when DAPT is warranted.
