“Perioperative management of anti-thrombotic treatment”

Publication date: Available online 29 January 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Alberto Zanetto, Marco Senzolo, Annabel BlasiAbstractEnd stage liver disease is characterized by multiple and complex alterations of hemostasis that are associated with an increased risk of both bleeding and thrombosis. Liver transplantation further challenges the feeble hemostatic balance of patients with decompensated cirrhosis, and the management of anti-thrombotic treatment during and after transplant surgery is particularly difficult. Bleeding was traditionally considered the major concern during and early after surgery, but it is increasingly recognized that transplant recipients may also develop thrombotic complications. Pathophysiology of hemostatic complications during and after transplantation is multifactorial and include pre-, intra-, and post-operative risk factors. Risk stratification is important, as it helps the identification of high-risk recipients in whom anti-thrombotic prophylaxis should be considered. In recipients who develop thrombosis during or after surgery, prompt treatment is indicated to prevent graft failure, re-transplantation, and death.

Source: Best Practice and Research Clinical Anaesthesiology - January 29, 2020 Category: Anesthesiology Source Type: research