Risk Factors and Management of Venous Thromboembolic Diseases in Donor of Living Donor Liver Transplant

Abstract

Background: liver transplantation surgically replaces a failing or diseased liver with one that is normal and healthy. At this time, transplantation is the only cure for liver insufficiency or liver failure because no device or machine reliably performs all of the functions of the liver. Aim of the Work: this study aimed to highlight risk factors of the venous thromboembolism in donors of living donor liver transplant and its management. Patients and Methods: this study included 40 patients who underwent hepatectomy for living donor liver transplant. All patients were evaluated extensively, including history and physical examination and specialty consultations when indicated. All patients did haematological studies to detect the risk factors of thromboembolic disease. Results: in patients with manifestations of venous thromboembolism 2 donors have single risk factor for venous thromboembolism and 4 donors have double risk factors. Conclusion: presence of multiple risk factors for venous thromboembolism led to increase in its incidence, so during preoperative assessment of the donors, if they have multiple risk factors for thrombosis some precautions should be taken to avoid venous thrombosis. Recommendations: preoperative precautions include heamatological consultations for the donors and prophylaxis dose of anticoagulant. Intra operative precautions included pneumatic calf pressure, elastic stocking. Finally postoperative precautions should be continued , these donors should take therapeutic doses of anticoagulants and follow up by lower limb venous duplex.

Catastrophic Antiphospholipid Syndrome after Orthotopic Liver Transplant

“…Bahaa El Din et al [ 17 ] completed a small review of 40 patients who underwent liver transplantation and found while ACAs did not provide significant evidence of producing venous thrombosis, LAs were a statistically significant indicator of venous thrombosis. Furmańczyk-Zawiska et al [ 18 ] completed a similar study determining whether the presence of APL would predict thrombotic risk and determined that the variable nature of ACAs make them an unreliable predictor of thrombotic events. Furmańczyk-Zawiska et al concluded that monitoring patients with APL is not necessary in liver transplant patient.…”