We report a case of a patient who underwent Living Donor Liver Transplantation (LDLT) while being continued on his dual antiplatelet regimen of clopidigrel and aspirin perioperatively. The patient had two drug eluting...We report a case of a patient who underwent Living Donor Liver Transplantation (LDLT) while being continued on his dual antiplatelet regimen of clopidigrel and aspirin perioperatively. The patient had two drug eluting stents for coronary artery disease placed eight months prior to surgery. Preoperative thromboelastography and platelet mapping showed normal clot formation. Based on these tests it was determined that preoperative platelet transfusion was not necessary. The surgery proceeded relatively uneventfully. The patient received 1 unit of packed red blood cells intraoperatively and continued on aspirin during the postoperative period with no evidence of bleeding or cardiac ischemia.展开更多
We report a case of a young kidney transplant candidate presented with severe and clinically completely asymptomatic mitral stenosis. The bedside Echocardiogram was helpful to establish the diagnosis. The surgery had ...We report a case of a young kidney transplant candidate presented with severe and clinically completely asymptomatic mitral stenosis. The bedside Echocardiogram was helpful to establish the diagnosis. The surgery had to be postponed and the patient was referred to a cardiologist for the further workup. This case report provides solid evidence that the renal transplant candidates are a very unique group of patients with specific disease development course. Their preoperative workup cannot be based on widely used guidelines from American College of Cardiology and American Heart Association that are relying on clinical symptoms and presentation of cardiac disease. All physicians who are involved in the care of these patients and making decisions about their candidacy for the transplantation should take into account severity and very often asymptomatic presentation of the cardiovascular complications of the end stage renal disease. This case provides a good example of the importance of the multispecialty involvement and coordination in perioperative care for prospective kidney transplant candidates.展开更多
文摘We report a case of a patient who underwent Living Donor Liver Transplantation (LDLT) while being continued on his dual antiplatelet regimen of clopidigrel and aspirin perioperatively. The patient had two drug eluting stents for coronary artery disease placed eight months prior to surgery. Preoperative thromboelastography and platelet mapping showed normal clot formation. Based on these tests it was determined that preoperative platelet transfusion was not necessary. The surgery proceeded relatively uneventfully. The patient received 1 unit of packed red blood cells intraoperatively and continued on aspirin during the postoperative period with no evidence of bleeding or cardiac ischemia.
文摘We report a case of a young kidney transplant candidate presented with severe and clinically completely asymptomatic mitral stenosis. The bedside Echocardiogram was helpful to establish the diagnosis. The surgery had to be postponed and the patient was referred to a cardiologist for the further workup. This case report provides solid evidence that the renal transplant candidates are a very unique group of patients with specific disease development course. Their preoperative workup cannot be based on widely used guidelines from American College of Cardiology and American Heart Association that are relying on clinical symptoms and presentation of cardiac disease. All physicians who are involved in the care of these patients and making decisions about their candidacy for the transplantation should take into account severity and very often asymptomatic presentation of the cardiovascular complications of the end stage renal disease. This case provides a good example of the importance of the multispecialty involvement and coordination in perioperative care for prospective kidney transplant candidates.
