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Anesth Analg 2006;102:724-728
© 2006 International Anesthesia Research Society
doi: 10.1213/01.ane.0000197779.03866.ad

CARDIOVASCULAR ANESTHESIA

Successful Intraoperative Use of Recombinant Tissue Plasminogen Activator During Liver Transplantation Complicated by Massive Intracardiac/Pulmonary Thrombosis

Douglas Jackson, MD, JD, Andrei Botea, MD, Yuriy Gubenko, MD, Ellise Delphin, MD, MPH, and Henry Bennett, PhD

Department of Anesthesiology, University of Medicine and Dentistry of New Jersey, Newark, New Jersey

Address correspondence and reprint requests to Douglas Jackson, MD, JD, Department of Anesthesiology, UMDNJ, MSB E-538b, 185 South Orange Avenue, Newark, NJ 07101. Address e-mail to jacksod1{at}umdnj.edu.

During orthotopic liver transplantation a patient received {varepsilon}-aminocaproic acid and clotting factors. Shortly after hepatic artery clamping the patient developed a massive intracardiac/intravascular thrombosis that resulted in cardiac arrest. After diagnosis by transesophageal echocardiography, the patient was treated with recombinant tissue plasminogen activator through a central venous catheter advanced into the right atrium. After treatment with recombinant tissue plasminogen activator, the patient’s hemodynamic status improved, permitting the liver transplant to be completed. The patient was ultimately discharged to home. We report the successful intraoperative resuscitation of a patient with acute intracardiac/intravascular thrombosis during an orthotopic liver transplantation using thrombolytic therapy.




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins and Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2006 by the International Anesthesia Research Society.