Incidence and risk factors for deep venous thrombosis and pulmonary embolus after liver transplantation

Abstract

Background: Omitting chemical venous thromboembolism prophylaxis in liver transplant recipients may lead to an increase incidence of deep venous thrombosis (DVT) and/or pulmonary embolus (PE).

Methods: A retrospective comparison of liver transplant recipients who developed postoperative DVT/PE to an age-matched population.

Results: Forty-three of eight hundred sixty-seven patients developed a DVT/PE. Study group patients received higher amounts of cryoprecipitate and fresh frozen plasma. Study group international normalized ratio (INR) was significantly higher, as was the incidence of postoperative complications. High-grade complication rates (bleeding, respiratory failure, and renal insufficiency) were increased in the study group at 16% vs 0%.

Conclusions: The present study demonstrates that the rate of DVT/PE after liver transplantation is similar to the rate after other major operations. Patients were more likely to develop DVT/PE if they received increased amounts of intraoperative cryoprecipitate/fresh frozen plasma (FFP) or had an elevated postoperative INR. Furthermore, patients with a complicated postoperative course have the highest risk of venous thromboembolism.

Keywords: Anticoagulation; DVT; Liver transplantation; PE.