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

The exact origin of intracardiac thrombi formation during orthotopic liver transplant remains unknown. The altered balance between hypercoagulability, hypocoagulation, and endothelial dysfunction associated with end-stage liver disease is thought to play a pivotal role. Venous stasis, vascular clamp...

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Main Authors:	Luigi Vetrugno, MD, Vittorio Cherchi, MD, PhD, Dario Lorenzin, MD, PhD, Francesco De Lorenzo, MD, Marco Ventin, MD, Victor Zanini, MD, Giovanni Terrosu, MD, Andrea Risaliti, MD, Umberto Baccarani, MD, PhD, Tiziana Bove, MD
Format:	Article
Language:	English
Published:	Wolters Kluwer 2021-10-01
Series:	Transplantation Direct
Online Access:	http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001200

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spelling	doaj-1001602232a2466c8f37396e37efb6032021-09-28T10:22:58ZengWolters KluwerTransplantation Direct2373-87312021-10-01710e74610.1097/TXD.0000000000001200202110000-00001The Challenging Management of an Intracardiac Thrombus in a Liver Transplant Patient at the Reperfusion Phase: A Case Report and Brief Literature ReviewLuigi Vetrugno, MD0Vittorio Cherchi, MD, PhD1Dario Lorenzin, MD, PhD2Francesco De Lorenzo, MD3Marco Ventin, MD4Victor Zanini, MD5Giovanni Terrosu, MD6Andrea Risaliti, MD7Umberto Baccarani, MD, PhD8Tiziana Bove, MD91 Department of Anesthesia and Intensive Care, University-Hospital of Udine, Udine, Italy.3 General Surgery Clinic and Liver Transplant Center, University-Hospital of Udine, Udine, Italy.3 General Surgery Clinic and Liver Transplant Center, University-Hospital of Udine, Udine, Italy.1 Department of Anesthesia and Intensive Care, University-Hospital of Udine, Udine, Italy.2 Department of Medicine, University of Udine, Italy, Udine, Italy.1 Department of Anesthesia and Intensive Care, University-Hospital of Udine, Udine, Italy.2 Department of Medicine, University of Udine, Italy, Udine, Italy.2 Department of Medicine, University of Udine, Italy, Udine, Italy.2 Department of Medicine, University of Udine, Italy, Udine, Italy.1 Department of Anesthesia and Intensive Care, University-Hospital of Udine, Udine, Italy.The exact origin of intracardiac thrombi formation during orthotopic liver transplant remains unknown. The altered balance between hypercoagulability, hypocoagulation, and endothelial dysfunction associated with end-stage liver disease is thought to play a pivotal role. Venous stasis, vascular clamping, and reperfusion could also contribute to clot formation. The incidence of intracardiac thrombi formation stands at 4.2%, associated with a mortality rate of 45.5%, and to date, no consensus exists regarding the best way to treat this complication. Intraoperative transesophageal echocardiography is the only effective method for diagnosing intracardiac thrombi formation early, while point-of-care coagulation testing could guide the coagulation management potentially improving patient outcomes.http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001200
collection	DOAJ
language	English
format	Article
sources	DOAJ
author	Luigi Vetrugno, MD Vittorio Cherchi, MD, PhD Dario Lorenzin, MD, PhD Francesco De Lorenzo, MD Marco Ventin, MD Victor Zanini, MD Giovanni Terrosu, MD Andrea Risaliti, MD Umberto Baccarani, MD, PhD Tiziana Bove, MD
spellingShingle	Luigi Vetrugno, MD Vittorio Cherchi, MD, PhD Dario Lorenzin, MD, PhD Francesco De Lorenzo, MD Marco Ventin, MD Victor Zanini, MD Giovanni Terrosu, MD Andrea Risaliti, MD Umberto Baccarani, MD, PhD Tiziana Bove, MD The Challenging Management of an Intracardiac Thrombus in a Liver Transplant Patient at the Reperfusion Phase: A Case Report and Brief Literature Review Transplantation Direct
author_facet	Luigi Vetrugno, MD Vittorio Cherchi, MD, PhD Dario Lorenzin, MD, PhD Francesco De Lorenzo, MD Marco Ventin, MD Victor Zanini, MD Giovanni Terrosu, MD Andrea Risaliti, MD Umberto Baccarani, MD, PhD Tiziana Bove, MD
author_sort	Luigi Vetrugno, MD
title	The Challenging Management of an Intracardiac Thrombus in a Liver Transplant Patient at the Reperfusion Phase: A Case Report and Brief Literature Review
title_short	The Challenging Management of an Intracardiac Thrombus in a Liver Transplant Patient at the Reperfusion Phase: A Case Report and Brief Literature Review
title_full	The Challenging Management of an Intracardiac Thrombus in a Liver Transplant Patient at the Reperfusion Phase: A Case Report and Brief Literature Review
title_fullStr	The Challenging Management of an Intracardiac Thrombus in a Liver Transplant Patient at the Reperfusion Phase: A Case Report and Brief Literature Review
title_full_unstemmed	The Challenging Management of an Intracardiac Thrombus in a Liver Transplant Patient at the Reperfusion Phase: A Case Report and Brief Literature Review
title_sort	challenging management of an intracardiac thrombus in a liver transplant patient at the reperfusion phase: a case report and brief literature review
publisher	Wolters Kluwer
series	Transplantation Direct
issn	2373-8731
publishDate	2021-10-01
description	The exact origin of intracardiac thrombi formation during orthotopic liver transplant remains unknown. The altered balance between hypercoagulability, hypocoagulation, and endothelial dysfunction associated with end-stage liver disease is thought to play a pivotal role. Venous stasis, vascular clamping, and reperfusion could also contribute to clot formation. The incidence of intracardiac thrombi formation stands at 4.2%, associated with a mortality rate of 45.5%, and to date, no consensus exists regarding the best way to treat this complication. Intraoperative transesophageal echocardiography is the only effective method for diagnosing intracardiac thrombi formation early, while point-of-care coagulation testing could guide the coagulation management potentially improving patient outcomes.
url	http://journals.lww.com/transplantationdirect/fulltext/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

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