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

Abstract

BackgroundOmitting chemical venous thromboembolism prophylaxis in liver transplant recipients may lead to an increase incidence of deep venous thrombosis (DVT) and/or pulmonary embolus (PE). MethodsA retrospective comparison of liver transplant recipients who developed postoperative DVT/PE to an age-matched population. ResultsForty-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%. ConclusionsThe 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.