Pulmonary thromboembolism during adult liver transplantation: Incidence, clinical presentation, outcome, risk factors, and diagnostic predictors

British Journal of Anaesthesia

Volumn 108, Issue 3, 2012, Pages 469-477

  Sakai, T ^a,b   Matsusaki, T ^a   Dai, F ^a,c   Tanaka, K A ^d   Donaldson, J B ^a   Hilmi, I A ^a   Wallis Marsh, J ^a   Planinsic, R M ^a   Humar, A ^a  

^a UNIVERSITY OF PITTSBURGH MEDICAL CENTER   (United States)

^b UNIVERSITY OF PITTSBURGH   (United States)

^c YALE UNIVERSITY   (United States)

^d EMORY UNIVERSITY HOSPITAL   (United States)

Author keywords

intraoperative complications; pulmonary embolism; retrospective study; thromboelastography

Indexed keywords

ADULT; AGED; ARTICLE; CLINICAL FEATURE; FEMALE; HUMAN; INCIDENCE; LIVER TRANSPLANTATION; LUNG EMBOLISM; MAJOR CLINICAL STUDY; MALE; PREDICTOR VARIABLE; PRIORITY JOURNAL; RISK FACTOR;

EID: 84863176870     PISSN: 00070912     EISSN: 14716771     Source Type: Journal    
DOI: 10.1093/bja/aer392     Document Type: Article

References (42)

1. Kang Y, Lewis JH, Navalgund A, et al. Epsilon-aminocaproic acid for treatment of fibrinolysis during liver transplantation. Anesthesiology 1987; 66: 766-73 (Pubitemid 17088976)
2. Navalgund AA, Kang Y, Sarner JB, Jahr JS, Gieraerts R. Massive pulmonary thromboembolism during liver transplantation. Anesth Analg 1988; 67: 400-2 (Pubitemid 18098948)
3. Warnaar N, Molenaar IQ, Colquhoun SD, et al. Intraoperative pulmonary embolism and intracardiac thrombosis complicating liver transplantation: a systematic review. J Thromb Haemost 2008; 6: 297-302
4. Lisman T, Bongers TN, Adelmeijer J, et al. Elevated levels of von Willebrand Factor in cirrhosis support platelet adhesion despite reduced functional capacity. Hepatology 2006; 44: 53-61 (Pubitemid 44049138)
5. Tripodi A, Mannucci PM. Abnormalities of hemostasis in chronic liver disease: reappraisal of their clinical significance and need for clinical and laboratory research. J Hepatol 2007; 46: 727-33 (Pubitemid 46400157)
6. Gologorsky E, de Wolf AM, Scott V, Aggarwal S, Dishart M, Kang Y. Intracardiac thrombus formation and pulmonary thromboembolism immediately after graft reperfusion in patients undergoing liver transplantation. Liver Transpl 2001; 7: 783-9 (Pubitemid 32851299)
7. Lerner AB, Sundar E, Mahmood F, Sarge T, Hanto DW, Panzica PJ. Four cases of cardiopulmonary thromboembolism during liver transplantation without the use of antifibrinolytic drugs. Anesth Analg 2005; 101: 1608-12 (Pubitemid 41720605)
8. Tzakis A, Todo S, Starzl TE. Orthotopic liver transplantation with preservation of the inferior vena cava. Ann Surg 1989; 210: 649-52 (Pubitemid 19271943)
9. Sakai T, Gligor S, Diulus J, McAffee R, Wallis Marsh J, Planinsic RM. Insertion and management of percutaneous veno-venous bypass cannula for liver transplantation: a reference for transplant anesthesiologists. Clin Transplant 2010; 24: 585-91
10. Kang YG. Clinical use of synthetic antifibrinolytic agents during liver transplantation. Semin Thromb Hemost 1993; 19: 258-61
11. Molenaar IQ, Warnaar N, Groen H, Tenvergert EM, Slooff MJ, Porte RJ. Efficacy and safety of antifibrinolytic drugs in liver transplantation; a systematic review and meta-analysis. Am J Transplant 2007; 7: 185-94 (Pubitemid 44952872)
12. Stein PD, Woodard PK, Weg JG, et al.; PIOPED II Investigators. Diagnostic pathways in acute pulmonary embolism: recommendations of the PIOPED II Investigators. Radiology 2007; 242: 15-21 (Pubitemid 44956005)
13. Cheriex EC, Sreeram N, Eussen YF, Pieters FA, Wellens HJ. Cross sectional Doppler echocardiography as the initial technique for the diagnosis of acute pulmonary embolism. Br Heart J 1994; 72: 52-7 (Pubitemid 24245385)
14. Mansencal N, Redheuil A, Joseph T, et al. Use of transthoracic echocardiography combined with venous ultrasonography in patients with pulmonary embolism. Int J Cardiol 2004; 96: 59-63 (Pubitemid 38760239)
15. Rudoni RR, Jackson RE, Godfrey GW, Bonfiglio AX, Hussey ME, Hauser AM. Use of two-dimensional echocardiography for the diagnosis of pulmonary embolus. J Emerg Med 1998; 16: 5-8 (Pubitemid 28087341)
16. Grifoni S, Olivotto I, Cecchini P, et al. Utility of an integrated clinical, echocardiographic, and venous ultrasonographic approach for triage of patients with suspected pulmonary embolism. Am J Cardiol 1998; 82: 1230-5 (Pubitemid 28541280)
17. Kamath PS, Kim WR; Advanced Liver Disease Study Group. The model for end-stage liver disease (MELD). Hepatology 2007; 45: 797-805 (Pubitemid 46450631)
18. Ben-Ari Z, Panagou M, Patch D, et al. Hypercoagulability in patients with primary biliary cirrhosis and primary sclerosing cholangitis evaluated by thrombelastography. J Hepatol 1997; 26: 554-9 (Pubitemid 27112720)
19. Feng S, Goodrich NP, Bragg-Gresham JL, et al. Characteristics associated with liver graft failure: the concept of a donor risk index. Am J Transplant 2006; 6: 783-90 (Pubitemid 43345017)
20. Aggarwal S, Kang Y, Freeman J, DeWolf AM, Begliomini B. Is there a post-reperfusion syndrome? Transplant Proc 1989; 21: 3497-9 (Pubitemid 20145175)
21. Cohen E, Caprini J, Zuckerman L, Vagher P, Robinson B. Evaluation of three methods used to identify accelerated coagulability. Thromb Res 1977; 10: 587-604 (Pubitemid 8076896)
22. TEGw 5000 User Manual PN06-510-TEG-User-Manual-v4.3- 2008-10[1]. IL, USA: Haemoscope Corporation Niles. Copyright & 1999-2007 by Haemoscope Corporation
23. El-Baghdadi MM, Sakai T. Fatal pulmonary embolism during liver transplantation in a patient with fulminant hepatic failure: a diagnostic challenge of the 'flat-line' thromboelastogram. J Cardiothorac Vasc Anesth 2010; 24: 641-3
24. Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR. A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol 1996; 49: 1373-9 (Pubitemid 27028925)
25. Sakai T, Matsusaki T, Marsh JW, Hilmi IA, Planinsic RM. Comparison of surgical methods in liver transplantation: retrohepatic caval resection with venovenous bypass (VVB) vs. Piggyback (PB) with VVB vs. PB without VVB. Transpl Int 2010; 23: 1247-58
26. O'Connor CJ, Roozeboom D, Brown R, Tuman KJ. Pulmonary thromboembolism during liver transplantation: possible association with antifibrinolytic drugs and novel treatment options. Anesth Analg 2000; 91: 296-9 (Pubitemid 30624284)
27. Boone JD, Sherwani SS, Herborn JC, Patel KM, De Wolf AM. The successful use of low-dose recombinant tissue plasminogen activator for treatment of intracardiac/pulmonary thrombosis during liver transplantation. Anesth Analg 2011; 112: 319-21
28. Szocik J, Rudich S, Csete M. ECMO resuscitation after massive pulmonary embolism during liver transplantation. Anesthesiology 2002; 97: 763-4 (Pubitemid 34977357)
29. Obray JB, Long TR, Rehfeldt KH, Wass CT. Cardiovascular collapse during elective orthopedic surgery: massive intraoperative pulmonary thromboembolism treated with emergent cardiopulmonary bypass. J Clin Anesth 2005; 17: 205-8 (Pubitemid 40719513)
30. Planinsic RM, Nicolau-Raducu R, Eghtesad B, Marcos A. Diagnosis and treatment of intracardiac thrombosis during orthotopic liver transplantation. Anesth Analg 2004; 99: 353-6 (Pubitemid 38970399)
31. Manji M, Isaac JL, Bion J. Survival from massive intraoperative pulmonary thromboembolism during orthotopic liver transplantation. Br J Anaesth 1998; 80: 685-7 (Pubitemid 28224936)
32. Reich DL, Wood RK Jr, Emre S, et al. Association of intraoperative hypotension and pulmonary hypertension with adverse outcomes after orthotopic liver transplantation. J Cardiothorac Vasc Anesth 2003; 17: 699-702 (Pubitemid 38044896)
33. Gosseye S, van Obbergh L, Weynand B, et al. Platelet aggregates in small lung vessels and death during liver transplantation. Lancet 1991; 338: 532-4
34. Dickson BC. Venous thrombosis: on the history of Virchow's triad. Univ Toronto Med J 2004; 81: 166-71
35. Sopher M, Braunfeld M, Shackleton C, Busuttil RW, Sangwan S, Csete M. Fatal pulmonary embolism during liver transplantation. Anesthesiology 1997; 87: 429-32 (Pubitemid 27435388)
36. Wong WH, Braunfeld M, Levin P. Recurrent pulmonary embolism during liver transplantation: possible role of hepatitis B immune globulin as a causative agent. Anesthesiology 2002; 96: 1261-3 (Pubitemid 34462590)
37. Snyder CW, Weinberg JA, McGwin G Jr, et al. The relationship of blood product ratio to mortality: survival benefit or survival bias? J Trauma 2009; 66: 358-62
38. Ramsay MA, Randall HB, Burton EC. Intravascular thrombosis and thromboembolism during liver transplantation: antifibrinolytic therapy implicated? Liver Transpl 2004; 10: 310-4 (Pubitemid 38240132)
39. Chari RS, Gan TJ, Robertson KM, et al. Venovenous bypass in adult orthotopic liver transplantation: routine or selective use? J Am Coll Surg 1998; 186: 683-90 (Pubitemid 28262239)
40. Shaw BW Jr, Martin DJ, Marquez JM, et al. Venous bypass in clinical liver transplantation. Ann Surg 1984; 200: 524-34 (Pubitemid 14024598)
41. Hong J, Larsson A, Ekdahl KN, Elgue G, Larsson R, Nilsson B. Contact between a polymer and whole blood: sequence of events leading to thrombin generation. J Lab Clin Med 2001; 138: 139-45 (Pubitemid 32696278)
42. Schumann R. Intraoperative resource utilization in anesthesia for liver transplantation in the United States: a survey. Anesth Analg 2003; 97: 21-8 (Pubitemid 36736532)