Rivaroxaban as Secondary Thromboprophylaxis in Pediatric Patients With Short Bowel Syndrome

Pediatric patients with short bowel syndrome often require long-term parenteral nutrition via a central venous catheter (CVC), which places them at risk for venous thromboembolism (VTE). Our objective was to retrospectively review a single-center use of rivaroxaban in patients with short bowel syndrome (n = 3) to determine if rivaroxaban is viable secondary thromboprophylaxis. One out of three patients developed a new VTE while their prophylactic rivaroxaban was held, one patient developed a gastrointestinal bleed, and one patient completed therapy without an event. Rivaroxaban may be feasible in selected patients with short bowel syndrome with close therapeutic drug level monitoring, but larger studies are needed.