Prothrombotic Disorders in a Cohort of 25 Patients Undergoing Transplantation: Investigation and Management Implications

Intestinal transplantation: The anesthesia perspective

“…Increased levels of low circulating levels of protein S, increased levels of factor V Leiden, and a higher incidence of active protein C resistance, antithrombin deficiency have been detected on thrombophilia screens [46,47]. Patients with identifiable or known thrombotic history can be considered to be at high risk for intraoperative thrombosis.…”

“…Patients with identifiable or known thrombotic history can be considered to be at high risk for intraoperative thrombosis. Some institutions anticoagulate high risk patients with low molecular weight heparin before and after intestinal transplantation and offer antiplatelet prophylaxis such as aspirin [47].…”

Postoperative Hemostasis Monitoring and Management

“…93 Bridging protocols are applied to those patients deemed at high risk for thrombotic Postoperative Hemostasis Monitoring and Management events (Box 2). [93][94][95][96][97] In this context, and for prophylaxis, LMWH therapy is initiated 2 to 3 days before the procedure, with the last dose given 24 hours before the procedure. Postoperatively, twice daily LMWH is used to avoid high peak concentrations soon after surgery.…”