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European Surgery

, Volume 42, Issue 1, pp 65–67 | Cite as

Use of sildenafil in a liver transplant recipient with acute pulmonary embolism

  • H. J. R. BonattiEmail author
  • R. G. Sawyer
  • K. D. Hagspiel
Short Communication

Summary

BACKGROUND: Pulmonary embolism (PE) can be a fatal complication after liver transplantation (LT). Sildenafil is commonly used in LT candidates with pulmonary hypertension but has not been used in this patient population in the setting of PE. METHODS: We report on a patient who developed PE early post LT. RESULTS: The patient presented with heart failure and shortness of breath, diagnosis of PE was made based on the documentation of lower limb venous thrombosis together with the findings of dilation of the right heart. Systemic heparin was given and sildenafil added in an attempt to lower the pulmonary pressure. The patient recovered from this severe complication and is currently alive with a well-functioning graft. CONCLUSIONS: Sildenafil seems to be a useful adjunct in the management of PE including LT recipients.

Keywords

Liver transplant Pulmonary embolism Sildenafil 

Einsatz von Sildenafil bei akuter Pulmonalarterienembolie nach Lebertransplantation

Zusammenfassung

GRUNDLAGEN: Pulmonalarterienembolie (PE) ist eine schwerwiegende Komplikation nach Lebertransplantation (LT). Sildenafil wird bei LT-Kandidaten mit pulmonaler Hypertension erfolgreich eingesetzt, keine Daten wurden bislang bei Einsatz nach PE berichtet. METHODIK: Wir berichten über eine Leberempfängerin, welche innerhalb weniger Tage nach LT eine PE entwickelte. ERGEBNISSE: Die Patientin entwickelte Dyspnoe und akutes Rechtsherzversagen. In der Echokardiographie fand sich ein dilatiertes rechtes Herz und im Ultraschall eine Beinvenenthrombose. Heparin wurde verabreicht und Sildenafil gegeben, um den Pulmonalarteriendruck akut zu senken. Die Patientin erholte sich von dieser schweren Komplikation und ist derzeit mit gut funktionierendem Transplantat am Leben. SCHLUSSFOLGERUNGEN: Sildenafil bietet sich als adjuvante Therapie bei massiver PE auch bei LT-Empfängern an.

Schlüsselwörter

Lebertransplantation Pulmonalarterienembolie Sildenafil 

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • H. J. R. Bonatti
    • 1
    Email author
  • R. G. Sawyer
    • 1
  • K. D. Hagspiel
    • 2
  1. 1.Department of SurgeryUniversity of Virginia Medical CenterCharlottesvilleUSA
  2. 2.Department of RadiologyUniversity of Virginia Medical CenterCharlottesvilleUSA

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