Significant Hyperfibrinolysis in a Patient With Intracardiac Thrombosis: To Give Antifibrinolytics or Not?
Abstract. The hemostatic system is a delicate balance between the coagulation, anticoagulation, and fibrinolytic systems and is responsible for preventing both hemorrhage and thrombosis. End stage liver disease is characterized by a rebalanced hemostatic system that is fragile and easily tipped towa...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2019-03-01
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| Series: | Transplantation Direct |
| Online Access: | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000000875 |
| _version_ | 1818678256588554240 |
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| author | Eric R. Simon, MD Christopher D. Darling, DO Laura L. Hammel, MD |
| author_facet | Eric R. Simon, MD Christopher D. Darling, DO Laura L. Hammel, MD |
| author_sort | Eric R. Simon, MD |
| collection | DOAJ |
| description | Abstract. The hemostatic system is a delicate balance between the coagulation, anticoagulation, and fibrinolytic systems and is responsible for preventing both hemorrhage and thrombosis. End stage liver disease is characterized by a rebalanced hemostatic system that is fragile and easily tipped towards either hemorrhage or thrombosis. During an orthotopic liver transplantation, patients are exposed to a wide variety of factors that can shift them from a hypercoagulable state to a hypocoagulable state almost instantaneously. The treatment for these two disease states contradict each other, and therefore patients in this condition can be extremely difficult to manage. Here, we present a patient who underwent an orthotopic liver transplantation and suffered an intracardiac thrombosis shortly after reperfusion of the donor graft, that resolved with supportive care, who then went on to develop severe persistent hyperfibrinolysis and massive hemorrhage that was successfully treated with an antifibrinolytic agent. |
| first_indexed | 2024-12-17T09:12:23Z |
| format | Article |
| id | doaj.art-56b603286dd94ec3969de01fb28e73b9 |
| institution | Directory Open Access Journal |
| issn | 2373-8731 |
| language | English |
| last_indexed | 2024-12-17T09:12:23Z |
| publishDate | 2019-03-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Transplantation Direct |
| spelling | doaj.art-56b603286dd94ec3969de01fb28e73b92022-12-21T21:55:09ZengWolters KluwerTransplantation Direct2373-87312019-03-0153e43110.1097/TXD.0000000000000875201903000-0005Significant Hyperfibrinolysis in a Patient With Intracardiac Thrombosis: To Give Antifibrinolytics or Not?Eric R. Simon, MD0Christopher D. Darling, DO1Laura L. Hammel, MD21Department of Anesthesiology, University of Wisconsin Hospitals and Clinics, Madison, WI.1Department of Anesthesiology, University of Wisconsin Hospitals and Clinics, Madison, WI.1Department of Anesthesiology, University of Wisconsin Hospitals and Clinics, Madison, WI.Abstract. The hemostatic system is a delicate balance between the coagulation, anticoagulation, and fibrinolytic systems and is responsible for preventing both hemorrhage and thrombosis. End stage liver disease is characterized by a rebalanced hemostatic system that is fragile and easily tipped towards either hemorrhage or thrombosis. During an orthotopic liver transplantation, patients are exposed to a wide variety of factors that can shift them from a hypercoagulable state to a hypocoagulable state almost instantaneously. The treatment for these two disease states contradict each other, and therefore patients in this condition can be extremely difficult to manage. Here, we present a patient who underwent an orthotopic liver transplantation and suffered an intracardiac thrombosis shortly after reperfusion of the donor graft, that resolved with supportive care, who then went on to develop severe persistent hyperfibrinolysis and massive hemorrhage that was successfully treated with an antifibrinolytic agent.http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000000875 |
| spellingShingle | Eric R. Simon, MD Christopher D. Darling, DO Laura L. Hammel, MD Significant Hyperfibrinolysis in a Patient With Intracardiac Thrombosis: To Give Antifibrinolytics or Not? Transplantation Direct |
| title | Significant Hyperfibrinolysis in a Patient With Intracardiac Thrombosis: To Give Antifibrinolytics or Not? |
| title_full | Significant Hyperfibrinolysis in a Patient With Intracardiac Thrombosis: To Give Antifibrinolytics or Not? |
| title_fullStr | Significant Hyperfibrinolysis in a Patient With Intracardiac Thrombosis: To Give Antifibrinolytics or Not? |
| title_full_unstemmed | Significant Hyperfibrinolysis in a Patient With Intracardiac Thrombosis: To Give Antifibrinolytics or Not? |
| title_short | Significant Hyperfibrinolysis in a Patient With Intracardiac Thrombosis: To Give Antifibrinolytics or Not? |
| title_sort | significant hyperfibrinolysis in a patient with intracardiac thrombosis to give antifibrinolytics or not |
| url | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000000875 |
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