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Consensus Statement on Hemostatic Management, Anticoagulation, and Antiplatelet Therapy in Liver Transplantation.
Montalvá, Eva; Rodríguez-Perálvarez, Manuel; Blasi, Annabel; Bonanad, Santiago; Gavín, Olga; Hierro, Loreto; Lladó, Laura; Llop, Elba; Pozo-Laderas, Juan Carlos; Colmenero, Jordi.
Afiliación
  • Montalvá E; Department of HPB Surgery and Transplantation, La Fe University Hospital and University of Valencia, Instituto de Investigación Sanitaria de La Fe, Valencia, Spain.
  • Rodríguez-Perálvarez M; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain.
  • Blasi A; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain.
  • Bonanad S; Department of Hepatology and Liver Transplantation, Reina Sofía University Hospital, IMIBIC, University of Córdoba, Córdoba, Spain.
  • Gavín O; Department of Anesthesiology, Hospital Clínic de Barcelona, IDIBAPS, CIBERehd, Barcelona, Spain.
  • Hierro L; Unidad de Hemostasia y Trombosis, Servicio de Hematología, Hospital Universitari i Politècnic La Fe, Valencia, Spain.
  • Lladó L; Departamento de Hematología y Hemoterapia, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.
  • Llop E; Department of Liver Transplantation, Hospital Universitario La Paz, Madrid, Spain.
  • Pozo-Laderas JC; Liver Transplant Unit, Department of Surgery, Bellvitge University Hospital, IDIBELL, University of Barcelona, Barcelona, Spain.
  • Colmenero J; Department of Hepatology and Liver Transplantation, Reina Sofía University Hospital, IMIBIC, University of Córdoba, Córdoba, Spain.
Transplantation ; 106(6): 1123-1131, 2022 06 01.
Article en En | MEDLINE | ID: mdl-34999660
Anticoagulation and antiplatelet therapies are increasingly used in liver transplant (LT) candidates and recipients due to cardiovascular comorbidities, portal vein thrombosis, or to manage posttransplant complications. The implementation of the new direct-acting oral anticoagulants and the recently developed antiplatelet drugs is a great challenge for transplant teams worldwide, as their activity must be monitored and their complications managed, in the absence of robust scientific evidence. In this changing and clinically heterogeneous scenario, the Spanish Society of Liver Transplantation and the Spanish Society of Thrombosis and Haemostasis aimed to achieve consensus regarding the indications, drugs, dosing, and timing of anticoagulation and antiplatelet therapies initiated from the inclusion of the patient on the waiting list to post-LT surveillance. A multidisciplinary group of experts composed by transplant hepatologists, surgeons, hematologists, transplant-specialized anesthesiologists, and intensivists performed a comprehensive review of the literature and identified 21 clinically relevant questions using the patient-intervention-comparison-outcome format. A preliminary list of recommendations was drafted and further validated using a modified Delphi approach by a panel of 24 transplant delegates, each representing a LT institution in Spain. The present consensus statement contains the key recommendations together with the core supporting scientific evidence, which will provide guidance for improved and more homogeneous clinical decision making.
Asunto(s)

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Trombosis / Hemostáticos / Trasplante de Hígado Tipo de estudio: Etiology_studies / Guideline / Prognostic_studies Límite: Humans Idioma: En Revista: Transplantation Año: 2022 Tipo del documento: Article País de afiliación: España

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Trombosis / Hemostáticos / Trasplante de Hígado Tipo de estudio: Etiology_studies / Guideline / Prognostic_studies Límite: Humans Idioma: En Revista: Transplantation Año: 2022 Tipo del documento: Article País de afiliación: España