Hepatic artery thrombosis and use of anticoagulants and antiplatelet agents in pediatric liver transplantation.
Document Type
Article
Publication Date
2-2024
Identifier
DOI: 10.1111/petr.14516
Abstract
BACKGROUND: Hepatic artery thrombosis (HAT) is a reported complication of 5%-10% of pediatric liver transplantations, rates 3-4 times that seen in adults. Early HAT (seen within 14 days after transplant) can lead to severe allograft damage and possible urgent re-transplantation. In this report, we present our analysis of HAT in pediatric liver transplant from a national clinical database and examine the association of HAT with anticoagulant or antiplatelet medication administered in the post-operative period.
METHODS: Data were obtained from the Pediatric Health Information System database maintained by the Children's Hospital Association. For each liver transplant recipient identified in a 10-year period, diagnosis, demographic, and medication data were collected and analyzed.
RESULTS: Our findings showed an average rate of HAT of 6.3% across 31 centers. Anticoagulant and antiplatelet medication strategies varied distinctly among and even within centers, likely due to the fact there are no consensus guidelines. Notably, in centers with similar medication usage, HAT rates continue to vary. At the patient level, use of aspirin within the first 72 h of transplantation was associated with a decreased risk of HAT, consistent with other reports in the literature.
CONCLUSION: We suggest that concerted efforts to standardize anticoagulation approaches in pediatric liver transplant may be of benefit in the prevention of HAT. A prospective multi-institutional study of regimen-possibly including aspirin-following transplantation could have significant value.
Journal Title
Pediatric transplantation
Volume
28
Issue
1
First Page
14516
Last Page
14516
MeSH Keywords
Adult; Child; Humans; Platelet Aggregation Inhibitors; Anticoagulants; Liver Transplantation; Hepatic Artery; Prospective Studies; Liver Diseases; Aspirin; Thrombosis; Retrospective Studies
Keywords
complication; liver allograft function/dysfunction; thrombosis and thromboembolism
Recommended Citation
Feldman K, Heble DE Jr, Hendrickson RJ, Fischer RT. Hepatic artery thrombosis and use of anticoagulants and antiplatelet agents in pediatric liver transplantation. Pediatr Transplant. 2024;28(1):e14516. doi:10.1111/petr.14516
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