ECMO Resuscitation after Massive Pulmonary Embolism during Liver Transplantation

Szocik, James; Rudich, Steven M.; Csete, Marie

doi:10.1097/00000542-200209000-00059

Cited by 41 publications

(30 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…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]. However, in general, FV Leiden is not associated with an increased risk of PE for surgical patients, and congenital thrombophilia disorders are thought to play only a minor role in the development of thromboembolic complications in these patients [57,58].…”

Section: Discussionmentioning

confidence: 99%

“…The most frequently described risk factors were venovenous bypass [13,15,18,[23][24][25]29,30,32,[34][35][36][38][39][40]45] and the use of antifibrinolytic medication [13,17,19,21,23,25,26,[28][29][30][31][32][34][35][36][37][38][39][42][43][44]. However, PE and ICT have been reported in almost an identical number of patients with or without these two putative risk factors (Table 3).…”

Section: Putative Risk Factorsmentioning

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

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: 99%

Section: Putative Risk Factorsmentioning

confidence: 99%

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

“…Extracorporeal membrane oxygenation is sporadically used in children with severe respiratory or cardiopulmonary failure secondary to a variety of causes such as acute hypoxemic respiratory failure, sepsis, trauma, immunosuppression, burns, bleeding disorders, and multiple organ systems failure [10][11][12]. Due to differences in patient selection, pre-ECMO patient characteristics and ECMO practice, the survival rates after pediatric ECMO are not uniform across centers [13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Factors associated with survival in pediatric extracorporeal membrane oxygenation—a single-center experience

Mehta¹,

Turner²,

Walsh³

et al. 2010

Journal of Pediatric Surgery

View full text Add to dashboard Cite

“…However, while this method of intervention is more aggressive, it has not been demonstrated to improve patient outcome [2, 3, 14]. Other acute rescue therapeutic modalities such as ECMO or the Angiovac system (AngioDynamics, Latham, NY) have been used [15]. …”

Section: Discussionmentioning

confidence: 99%

Emergent Management of Intracardiac Thrombosis during Liver Transplantation

Protin

Bezinover

Kadry

et al. 2016

Case Reports in Transplantation

View full text Add to dashboard Cite

Intraoperative thromboembolism is a well-documented complication associated with orthotopic liver transplantation (OLT) but its identification and intraoperative treatment are still an emerging topic in anesthesia. Intracardiac thrombus during OLT is associated with a high mortality rate. There are only a few reports describing the successful management of thromboembolism during OLT. We describe a case where routine intraoperative transesophageal echocardiography during a live donor liver transplantation enabled early detection of an intracardiac thrombus with subsequent successful heparin treatment. Our case suggests that if an intracardiac thrombus is identified early (before hemodynamic instability occurs), the use of IV heparin may be a safe therapeutic option.

show abstract

ECMO Resuscitation after Massive Pulmonary Embolism during Liver Transplantation

Cited by 41 publications

References 0 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

Factors associated with survival in pediatric extracorporeal membrane oxygenation—a single-center experience

Emergent Management of Intracardiac Thrombosis during Liver Transplantation

Contact Info

Product

Resources

About