04 July 2017 : Original article
Donor Selection and Prophylactic Strategy for Venous Thromboembolic Events in Living Donors of Liver Transplantation Based on Results of Thrombophilia Screening TestsHideya Kamei1ABCDEF*, Yasuharu Onishi1B, Nobuhiko Kurata1B, Masatoshi Ishigami2D, Yasuhiro Ogura1A
Ann Transplant 2017; 22:409-416
BACKGROUND: We reported a strategy of thrombophilia testing-guided venous thromboembolic events (VTE) prophylaxis for living donors of liver transplantation in 2011. The aim of the present study was to evaluate the safety and efficacy of this protocol for VTE prophylaxis.
MATERIAL AND METHODS: Thrombophilia testing, including protein S (PS), protein C (PC), antithrombin (AT) III, and anti-phospholipid antibody (APLA), was performed in 306 living donor candidates between July 2005 and June 2016. Donors who met any of the criteria of PS <60%, PC <64%, AT-III <70%, and positive APLA were classified into the borderline group and received continuous venous infusion of heparin immediately after surgery, in addition to use of elastic stockings and intermittent pneumatic compression (IPC) until patients were ambulatory. Other donors who were classified into the normal group used elastic stockings and IPC with no anticoagulants. The efficacy and safety endpoints were VTE occurrence and bleeding events, respectively.
RESULTS: PS was considerably decreased in 3 candidates and PC was considerably reduced in 1 candidate, and they were excluded for high risk of VTE. Seventeen candidates in the borderline group and 137 in the normal group underwent donor surgery. One donor in the borderline group developed a wound hematoma. Postoperative complications were similar between the 2 groups. None of the donors in either group developed VTE.
CONCLUSIONS: Thrombophilia testing-guided VTE prophylaxis is safe and may contribute to reduced VTE risk in donors, although further investigations are warranted to assess the necessity of thrombophilia testing prior to surgery among living donors.
Keywords: Donor Selection, Liver, Living Donors, Postoperative Complications, Safety Management, Venous Thrombosis
17 May 2023 : Original articleResults of Liver Retransplantation After Rescue Hepatectomy: A Single-Center Study
Ann Transplant In Press; DOI: 10.12659/AOT.939557
10 May 2023 : Case reportOutcomes from a Single Transplant Center of 5 Pediatric Cases of Domino Liver Transplantation from Live Don...
Ann Transplant In Press; DOI: 10.12659/AOT.939893
Most Viewed Current Articles
24 Aug 2021 : Review articleNormothermic Machine Perfusion (NMP) of the Liver – Current Status and Future Perspectives
Ann Transplant 2021; 26:e931664
26 Jan 2022 : Review articleRecurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive Models
Ann Transplant 2022; 27:e934924
29 Dec 2021 : Original articleEfficacy and Safety of Tacrolimus-Based Maintenance Regimens in De Novo Kidney Transplant Recipients: A Sys...
Ann Transplant 2021; 26:e933588
15 Mar 2022 : Case reportCombined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...
Ann Transplant 2022; 27:e935860