Faculty Collaboration Database

Perioperative anticoagulation practices for pediatric liver transplantation. Pediatr Transplant 2018 Jun;22(4):e13193

Date

04/18/2018

Pubmed ID

29663585

DOI

10.1111/petr.13193

Scopus ID

2-s2.0-85047854251 (requires institutional sign-in at Scopus site)   19 Citations

Abstract

Despite continued advancements in perioperative care for pediatric liver transplant (LT), graft-threatening vascular occlusion events including hepatic artery thrombosis (HAT) and portal vein thrombosis (PVT) remain a source of significant morbidity and mortality. Perioperative anticoagulation is commonly used for the prevention of HAT and PVT, but evidence-based guidelines are lacking. The goals of this survey were to determine the frequency of use of an anticoagulation protocol and to describe variation in anticoagulation practices among pediatric LT centers. The study consisted of an online survey distributed to members of SPLIT. The survey focused on institutional anticoagulation practices employed to reduce the incidence of graft and life-threatening vascular occlusion events. Responses were received from 31 of 39 SPLIT centers. All respondents report using anticoagulation after pediatric LT, and approximately 90% have institutional anticoagulation protocols. Subgroup analysis of high volume pediatric LT centers revealed similar variability in anticoagulation patterns. All participating SPLIT centers reported the use of post-transplant anticoagulation and nearly all use a protocol. However, there is marked variability in the type and dose of anticoagulation as well as the timing of initiation and duration of therapy across centers.

Author List

Voulgarelis S, Vitola B, Lerret SM, Hong JC, Scott JP

Authors

Stacee Lerret PhD Professor Hybrid in the Pediatrics department at Medical College of Wisconsin
John P. Scott MD Professor in the Anesthesiology department at Medical College of Wisconsin
Bernadette Vitola MD, MPH Associate Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Anticoagulants
Australia
Canada
Child
Clinical Protocols
Health Care Surveys
Humans
Liver Transplantation
Pediatrics
Perioperative Care
Postoperative Complications
Practice Patterns, Physicians'
Quality Improvement
Thrombosis
United States