The Challenging Management of an Intracardiac Thrombus in a Liver Transplant Patient at the Reperfusion Phase: A Case Report and Brief Literature Review

Vetrugno, Luigi; Cherchi, Vittorio; Lorenzin, Dario; Lorenzo, Francesco De; Ventin, Marco; Zanini, Victor; Terrosu, Giovanni; Risaliti, Andrea; Baccarani, Umberto; Bove, Tiziana

doi:10.1097/txd.0000000000001200

Transplantation Direct

2021

DOI: 10.1097/txd.0000000000001200

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The Challenging Management of an Intracardiac Thrombus in a Liver Transplant Patient at the Reperfusion Phase: A Case Report and Brief Literature Review

Luigi Vetrugno

Vittorio Cherchi

Dario Lorenzin

et al.

Abstract: Supplemental Digital Content is available in the text.

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Cited by 5 publications

(2 citation statements)

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“…3,4 Regarding coagulation, our center currently uses the rotational trhombo elastrometry system with high attention to spare plasma if the Extem/Fibtem samples suggests using prothrombin complex or fibrinogen. 5 Overall, we agree with Yehuda and Ramona and adhere to the call that an association does not imply causation, in fact in our investigation we carefully avoided to point out diastolic dysfunction as a "risk factor" of EAD at the moment and further studies are required to respond whether like -Oedipus -diastolic dysfunction is guilty, or innocent.…”

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confidence: 71%

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Diastolic dysfunction and early liver allograft dysfunction: Like Oedipus

et al. 2022

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supporting

confidence: 71%

“…Regarding coagulation, our center currently uses the rotational trhombo elastrometry system with high attention to spare plasma if the Extem/Fibtem samples suggests using prothrombin complex or fibrinogen 5 …”

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confidence: 99%

Diastolic dysfunction and early liver allograft dysfunction: Like Oedipus

et al. 2022

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Impact of graft reperfusion on cardiac function assessed by transesophageal echocardiography during liver transplantation: an observational retrospective study

González-Suárez,

Corbett,

Hernández-Martínez

2023

J Clin Monit Comput

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Cardiovascular instability is common during the reperfusion phase of orthotopic liver transplantation (OLT), and some patients experience a postreperfusion syndrome (PRS). However, there are no reports comparing the cardiac dysfunction between patients with PRS and those without. Thus, the aim of this study was to evaluate cardiac dysfunction in patients exhibiting PRS. This observational retrospective study included 34 patients who underwent OLT and were monitored with transesophageal echocardiography (TEE). The right ventricular/left ventricular (RV/LV) end diastolic area, tricuspid annular plane systolic excursion (TAPSE), left ventricular ejection fraction (LVEF) by Simpson method, pulsed Doppler of the mitral valve, and tissue Doppler motion of the mitral annulus were determined. Echocardiographic measurements were registered at the beginning of surgery and at 1 and 30 min after vascular unclamping. Patients with PRS (PRS group) were identified, and their echocardiographic parameters of ventricular function were compared with those in patients without PRS (non-PRS group). To check the evolution of diastolic-systolic dysfunction, general linear model-repeated measures were estimated. No patient presented systolic/diastolic dysfunction on the basal echocardiogram. One minute after vascular unclamping, the incidence of RV dilation was 4.5 times greater in patients with PRS (Cramer´s V > 0.6), and the incidence of RV systolic dysfunction was 62.5% in patients with PRS compared to 15.40% in patients without PRS (Cramer´s V = 0.45). The incidence of LV systolic dysfunction was 25% in patients with PRS compared to 0% in those without (Cramer´s V = 0.45), and left ventricular diastolic dysfunction was 4.8 times greater in patients with PRS (Cramer´s V = 0.45). No patient presented diastolic dysfunction type III. There were significant differences between groups in the evolutionary pattern at 1 and 30 min after unclamping for RV dilation (p = 0.008) and for TAPSE (p = 0.014). Liver graft reperfusion may alter cardiac function. Cardiac dysfunction was more frequent in patients with PRS. These patients exhibited temporary dysfunction of the RV associated with a varying degree of LV diastolic-systolic dysfunction. Trial registration: clinicaltrials.gov (NCT05175534). January 03, 2022; “retrospectively registered”.

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Intracardiac thrombosis and pulmonary thromboembolism during liver transplantation: A systematic review and meta-analysis

Kumar¹,

Flores²,

Mitchell³

et al. 2023

American Journal of Transplantation

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The Challenging Management of an Intracardiac Thrombus in a Liver Transplant Patient at the Reperfusion Phase: A Case Report and Brief Literature Review

Abstract: Supplemental Digital Content is available in the text.

Cited by 5 publications

References 12 publications

Diastolic dysfunction and early liver allograft dysfunction: Like Oedipus

Diastolic dysfunction and early liver allograft dysfunction: Like Oedipus

Impact of graft reperfusion on cardiac function assessed by transesophageal echocardiography during liver transplantation: an observational retrospective study

Intracardiac thrombosis and pulmonary thromboembolism during liver transplantation: A systematic review and meta-analysis

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