Pulmonary Embolism in a Donor of Living Donor Liver Transplantation

Pulmonary embolism (PE) is a rare but potentially fatal complication that may develop in a living liver donor. Here, we report a case of non-massive PE diagnosed by elevated serum D-dimer levels and successfully treated using anticoagulant therapy. A 57-year-old man underwent extended left hepatecto...

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Main Authors: Shinji Onda, Hiroaki Shiba, Taro Sakamoto, Kenei Furukawa, Takeshi Gocho, Katsuhiko Yanaga
Format: Article
Language:English
Published: Karger Publishers 2019-06-01
Series:Case Reports in Gastroenterology
Subjects:
Online Access:https://www.karger.com/Article/FullText/501068
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author Shinji Onda
Hiroaki Shiba
Taro Sakamoto
Kenei Furukawa
Takeshi Gocho
Katsuhiko Yanaga
author_facet Shinji Onda
Hiroaki Shiba
Taro Sakamoto
Kenei Furukawa
Takeshi Gocho
Katsuhiko Yanaga
author_sort Shinji Onda
collection DOAJ
description Pulmonary embolism (PE) is a rare but potentially fatal complication that may develop in a living liver donor. Here, we report a case of non-massive PE diagnosed by elevated serum D-dimer levels and successfully treated using anticoagulant therapy. A 57-year-old man underwent extended left hepatectomy as a living liver donor. His past medical history included hypertension and dyslipidemia which required medication and a history of smoking. Mechanical prophylactic measures for venous thromboembolism, including intermittent pneumatic compression and elastic stocking, were used; however, no pharmacological prophylaxis was used. Although the patient ambulated on postoperative day (POD) 1, he developed hypoxia. Serum D-dimer level was elevated to 29.3 ng/mL on POD 2. Enhanced computed tomography revealed small peripheral PEs in the branches of the right upper, right middle, and left lower lobes without deep vein thrombosis. Intravenous heparin was initiated followed by warfarin. The thrombi resolved completely by POD 13, following which warfarin was continued for 3 months. As of 25 months after donation, the patient remains well without recurrence of PE. Early diagnosis and treatment of postoperative PE are critical for preventing mortality of liver donors.
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spelling doaj.art-0685029ffd7b4661ade36e707be8e5a62022-12-21T17:57:44ZengKarger PublishersCase Reports in Gastroenterology1662-06312019-06-0113225826410.1159/000501068501068Pulmonary Embolism in a Donor of Living Donor Liver TransplantationShinji OndaHiroaki ShibaTaro SakamotoKenei FurukawaTakeshi GochoKatsuhiko YanagaPulmonary embolism (PE) is a rare but potentially fatal complication that may develop in a living liver donor. Here, we report a case of non-massive PE diagnosed by elevated serum D-dimer levels and successfully treated using anticoagulant therapy. A 57-year-old man underwent extended left hepatectomy as a living liver donor. His past medical history included hypertension and dyslipidemia which required medication and a history of smoking. Mechanical prophylactic measures for venous thromboembolism, including intermittent pneumatic compression and elastic stocking, were used; however, no pharmacological prophylaxis was used. Although the patient ambulated on postoperative day (POD) 1, he developed hypoxia. Serum D-dimer level was elevated to 29.3 ng/mL on POD 2. Enhanced computed tomography revealed small peripheral PEs in the branches of the right upper, right middle, and left lower lobes without deep vein thrombosis. Intravenous heparin was initiated followed by warfarin. The thrombi resolved completely by POD 13, following which warfarin was continued for 3 months. As of 25 months after donation, the patient remains well without recurrence of PE. Early diagnosis and treatment of postoperative PE are critical for preventing mortality of liver donors.https://www.karger.com/Article/FullText/501068Postoperative venous thromboembolismLiving donor liver transplantationLife-threatening complication
spellingShingle Shinji Onda
Hiroaki Shiba
Taro Sakamoto
Kenei Furukawa
Takeshi Gocho
Katsuhiko Yanaga
Pulmonary Embolism in a Donor of Living Donor Liver Transplantation
Case Reports in Gastroenterology
Postoperative venous thromboembolism
Living donor liver transplantation
Life-threatening complication
title Pulmonary Embolism in a Donor of Living Donor Liver Transplantation
title_full Pulmonary Embolism in a Donor of Living Donor Liver Transplantation
title_fullStr Pulmonary Embolism in a Donor of Living Donor Liver Transplantation
title_full_unstemmed Pulmonary Embolism in a Donor of Living Donor Liver Transplantation
title_short Pulmonary Embolism in a Donor of Living Donor Liver Transplantation
title_sort pulmonary embolism in a donor of living donor liver transplantation
topic Postoperative venous thromboembolism
Living donor liver transplantation
Life-threatening complication
url https://www.karger.com/Article/FullText/501068
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