©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Mar 24, 2015; 5(1): 34-37
Published online Mar 24, 2015. doi: 10.5500/wjt.v5.i1.34
Published online Mar 24, 2015. doi: 10.5500/wjt.v5.i1.34
Diagnostic dilemma of coagulation problems in an HIV-positive patient with end-stage liver disease undergoing liver transplantation
Ali Abdullah, Department of Anesthesiology and Critical Care Medicine, Allegheny General Hospital, Pittsburgh, PA 15212, United States
Ibtesam A Hilmi, Department of Anesthesiology, Clinical and Translational Science Institute, University of Pittsburgh School of Medicine, UPMC Presbyterian Hospital, Pittsburgh, PA 15213, United States
Raymond Planinsic, Department of Anesthesiology, University of Pittsburgh School of Medicine, UPMC Presbyterian Hospital, Pittsburgh, PA 15213, United States
Author contributions: All authors contributed to this manuscript.
Conflict-of-interest: All authors have no conflict of interest to declare.
Correspondence to: Ibtesam A Hilmi, MBCHB, FRCA, Associate Professor, Director of QI/QA, Department of Anesthesiology, Clinical and Translational Science Institute, University of Pittsburgh School of Medicine, UPMC Presbyterian Hospital, 200 Lothrop St, Pittsburgh, PA 15213, United States. hilmiia@anes.upmc.edu
Telephone: +1-412-6473262 Fax: +1-412-6479260
Received: March 14, 2014
Peer-review started: March 14, 2014
First decision: April 18, 2014
Revised: December 2, 2014
Accepted: December 29, 2014
Article in press: December 31, 2014
Published online: March 24, 2015
Processing time: 375 Days and 11.5 Hours
Peer-review started: March 14, 2014
First decision: April 18, 2014
Revised: December 2, 2014
Accepted: December 29, 2014
Article in press: December 31, 2014
Published online: March 24, 2015
Processing time: 375 Days and 11.5 Hours
Core Tip
Core tip: Liver transplantation is a technically complicated procedure associated with both predictable and unpredictable coagulation abnormalities. The surgeons are more concerned about bleeding than thrombotic complications in cirrhotic patients undergoing liver transplant, but the reality these patients are equally at risk of both complications. The risk of a thrombotic event is even higher in human immunodeficiency virus (HIV) patients on highly active antiretroviral therapy (HAART) both during and after the surgical procedure. This fact should be ranked high in the differential diagnosis of liver allograft failure in liver transplant recipients who are HIV positive and receiving HAART.