Platelet aggregates in small lung vessels and death during liver transplantation

Gosseye, Serge; Weynand, Birgit; Obbergh, Luc Van; Scheiff, Jean-Marie; Moulin, D.; Goyet, Jean de Ville de; Otté, Jean-Bernard

doi:10.1016/0140-6736(91)91099-g

Cited by 27 publications

(29 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, in the current review of 74 patients with PE and/or ICT, 34 (46%) did not receive any antifibrinolytic drug [13,15,16,20,22,24,27,36,40,41,43]. These numbers may even be influenced by a reporting bias, as it is likely that thrombotic complications are less frequently reported when no potential cause can be identified or when no antifibrinolytic drug is given to the patient.…”

Section: Discussionmentioning

confidence: 68%

“…Infectious conditions, however, are a well-defined and strong risk factor for thrombotic events, and this effect may last for weeks after the septic episode [55,56]. Other suggested risk factors are certain drugs and blood products, such as hepatitis B immunoglobulin [24,31,34], the combination of aprotinin and octreotide [37], solvent-detergent plasma [36], and large volumes of cryoprecipitate, fresh frozen plasma or platelet concentrates [20,21,23]. The potential role of acquired and congenital thrombophilia disorders, such as protein C, protein S, or antithrombin III deficiencies or factor (F) V Leiden mutation, has been investigated in only a small number of patients [17,27,29,32].…”

Section: Discussionmentioning

confidence: 99%

“…Although some authors have tried to emphasize the critical role of other risk factors, such as the use of pulmonary artery catheters [17,20,25,26,35] or certain blood products [24,31,34,36,37], none of these or other putative risk factors appeared to be universally present in a high percentage of the patients (Table 3).…”

Section: Putative Risk Factorsmentioning

confidence: 99%

See 2 more Smart Citations

Intraoperative pulmonary embolism and intracardiac thrombosis complicating liver transplantation: a systematic review

Warnaar¹,

Molenaar²,

Colquhoun³

et al. 2008

J Thromb Haemost

122

View full text Add to dashboard Cite

Summary. Background: Pulmonary embolism (PE) and intracardiac thrombosis (ICT) are rare but potentially lethal complications during orthotopic liver transplantation (OLT). Methods: We aimed to review clinical and pathological correlates of PE and ICT in patients undergoing OLT. A systematic review of the literature was conducted using MEDLINE and ISI Web of Science. Results: Seventy-four cases of intraoperative PE and/or ICT were identified; PE alone in 32 patients (43%) and a combination of PE and ICT in 42 patients (57%). Most frequent clinical symptoms included systemic hypotension and concomitant rising pulmonary artery pressure, often leading to complete circulatory collapse. PE and ICT occurred in every stage of the operation and were reported equally in patients with or without the use of venovenous bypass or antifibrinolytics. A large variety of putative risk factors have been suggested in the literature, including the use of pulmonary artery catheters or certain blood products. Nineteen patients underwent urgent thrombectomy or thrombolysis. Overall mortality was 68% (50/74) and 41 patients (82%) died intraoperatively. Conclusion: Mortality was significantly higher in patients with an isolated PE, compared to patients with a combination of PE and ICT (91% and 50%, respectively; P < 0.001). Intraoperative PE and ICT during OLT appear to have multiple etiologies and may occur unexpectedly at any time during the procedure.

show abstract

Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Intraoperative pulmonary embolism and intracardiac thrombosis complicating liver transplantation: a systematic review

Warnaar¹,

Molenaar²,

Colquhoun³

et al. 2008

J Thromb Haemost

122

View full text Add to dashboard Cite

show abstract

“…To date, 34 patients with severe PTE and RV failure have been reported during OLT. Almost all these adult patients were monitored with a PAC, 16 received antifibrinolytics and 24 ultimately died because of refractory low CO and multiorgan failure [2,[4][5][6][7][8][9][10][11][12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular collapse due to massive pulmonary thromboembolism during orthotopic liver transplantation

Ellenberger

Mentha

Giostra

et al. 2006

Journal of Clinical Anesthesia

View full text Add to dashboard Cite

“…Some histological assessments also suggest the hypothesis of an activation of coagulation associated with OLT that aprotinin could potentially worsen (47,48). Gosseye et al (47) reported the histological data of 10 of 219 children Ͻ15 yr of age undergoing OLT who died suddenly during the procedure.…”

Section: Postmortem Findingsmentioning

confidence: 96%

A Review of Aprotinin in Orthotopic Liver Transplantation: Can Its Harmful Effects Offset Its Beneficial Effects?

Lentschener

Roche²,

Ozier³

2005

Anesthesia & Analgesia

View full text Add to dashboard Cite

Blood transfusion can adversely affect patient outcome and graft survival in orthotopic liver transplantation (OLT). With this respect, prophylactic aprotinin administration decreases blood loss, transfusion requirements, and the hemodynamic changes associated with graft reperfusion in patients undergoing OLT. However, data indicate limiting the use of aprotinin in OLT: (a) clinical, biological, echocardiographic, and postmortem findings recorded in patients with chronic liver disease or undergoing OLT suggest that a continuous prothrombotic state exists in these patients. Whether the inhibition of fibrinolysis associated with aprotinin therapy will expose some patients to untoward thrombosis is questionable; (b) aprotinin does not appear to alter postoperative outcome in patients undergoing OLT; (c) aprotinin decreases blood transfusion requirements only when surgery is associated with significant blood loss. However, at the present time, median transfusion requirements of 2 to 5 red blood cell units are required in OLT.

show abstract

Platelet aggregates in small lung vessels and death during liver transplantation

Cited by 27 publications

References 11 publications

Intraoperative pulmonary embolism and intracardiac thrombosis complicating liver transplantation: a systematic review

Intraoperative pulmonary embolism and intracardiac thrombosis complicating liver transplantation: a systematic review

Cardiovascular collapse due to massive pulmonary thromboembolism during orthotopic liver transplantation

A Review of Aprotinin in Orthotopic Liver Transplantation: Can Its Harmful Effects Offset Its Beneficial Effects?

Contact Info

Product

Resources

About