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

T. Sakai, Takashi Matsusaki, F. Dai, K. A. Tanaka, J. B. Donaldson, I. A. Hilmi, J. Wallis Marsh, R. M. Planinsic, A. Humar

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

Background. Intraoperative pulmonary thromboembolism (PTE) is an often overlooked cause of mortality during adult liver transplantation (LT) with diagnostic challenge. The goals of this study were to investigate the incidence, clinical presentation, and outcome of PTE and to identify risk factors or diagnostic predictors for PTE. Methods. Four hundred and ninety-five consecutive, isolated, deceased donor LTs performed in an institution for a 3 yr period (20046) were analysed. The standard technique was a piggyback method with veno-venous bypass without prophylactic anti-fibrinolytics. The clinical diagnosis of PTE was made with (i) acute cor pulmonale, and (ii) identification of blood clots in the pulmonary artery or observation of acute right heart pressure overload with or without intracardiac clots with transoesophageal echocardiography. Results. The incidence of PTE was 4.0 (20 cases); cardiac arrest preceded the diagnosis of PTE [75 (15)] and PTE occurred during the neo-hepatic phase [85 (17)], especially within 30 min after graft reperfusion [70 (14)]. Operative and 60 day mortalities of patients with PTE were higher (P

Original languageEnglish
Pages (from-to)469-477
Number of pages9
JournalBritish Journal of Anaesthesia
Volume108
Issue number3
DOIs
Publication statusPublished - Mar 2012
Externally publishedYes

Fingerprint

Pulmonary Embolism
Liver Transplantation
Incidence
Pulmonary Heart Disease
Mortality
Transesophageal Echocardiography
Heart Arrest
Pulmonary Artery
Reperfusion
Thrombosis
Observation
Tissue Donors
Transplants
Pressure
Liver

Keywords

  • intraoperative complications
  • pulmonary embolism
  • retrospective study
  • thromboelastography

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Pulmonary thromboembolism during adult liver transplantation : Incidence, clinical presentation, outcome, risk factors, and diagnostic predictors. / Sakai, T.; Matsusaki, Takashi; Dai, F.; Tanaka, K. A.; Donaldson, J. B.; Hilmi, I. A.; Wallis Marsh, J.; Planinsic, R. M.; Humar, A.

In: British Journal of Anaesthesia, Vol. 108, No. 3, 03.2012, p. 469-477.

Research output: Contribution to journalArticle

Sakai, T. ; Matsusaki, Takashi ; Dai, F. ; Tanaka, K. A. ; Donaldson, J. B. ; Hilmi, I. A. ; Wallis Marsh, J. ; Planinsic, R. M. ; Humar, A. / Pulmonary thromboembolism during adult liver transplantation : Incidence, clinical presentation, outcome, risk factors, and diagnostic predictors. In: British Journal of Anaesthesia. 2012 ; Vol. 108, No. 3. pp. 469-477.
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