Do postliver transplant patients need thromboprophylactic anticoagulation?

Clin Appl Thromb Hemost. 2014 Oct;20(7):673-7. doi: 10.1177/1076029614538490. Epub 2014 Jun 10.

Abstract

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: anticoagulants; deep venous thrombosis; thrombosis prophylaxis; venous thromboembolism.

Publication types

  • Review

MeSH terms

  • Anticoagulants / therapeutic use*
  • Budd-Chiari Syndrome / etiology
  • Budd-Chiari Syndrome / prevention & control*
  • Humans
  • International Normalized Ratio
  • Liver Transplantation / adverse effects*
  • Postoperative Complications / prevention & control*
  • Pulmonary Embolism / etiology
  • Pulmonary Embolism / prevention & control*

Substances

  • Anticoagulants