Dalal A. Organ transplantation and drug eluting stents: Perioperative challenges. World J Transplant 2016; 6(4): 620-631 [PMID: 28058211 DOI: 10.5500/wjt.v6.i4.620]
Corresponding Author of This Article
Aparna Dalal, MD, Assistant Professor, Department of Anesthesiology, Icahn School of Medicine, Mount Sinai 1428 Madison Avenue, New York, NY 10029, United States. dalalanesthesia@gmail.com
Research Domain of This Article
Transplantation
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplant. Dec 24, 2016; 6(4): 620-631 Published online Dec 24, 2016. doi: 10.5500/wjt.v6.i4.620
Organ transplantation and drug eluting stents: Perioperative challenges
Aparna Dalal
Aparna Dalal, Department of Anesthesiology, Icahn School of Medicine, New York, NY 10029, United States
Author contributions: Dalal A authored the paper.
Conflict-of-interest statement: The author has not received any financial support for this review article, nor has any conflicts of interest to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Aparna Dalal, MD, Assistant Professor, Department of Anesthesiology, Icahn School of Medicine, Mount Sinai 1428 Madison Avenue, New York, NY 10029, United States. dalalanesthesia@gmail.com
Telephone: +1-216-2722545 Fax:+1-646-6853610
Received: March 16, 2016 Peer-review started: March 18, 2016 First decision: May 19, 2016 Revised: July 28, 2016 Accepted: September 13, 2016 Article in press: September 15, 2016 Published online: December 24, 2016
Core Tip
Core tip: Patients undergoing transplant surgery soon after the placement of drug eluting stents (DES) are at increased risk of stent thrombosis (ST) in the perioperative period. Dual antiplatelet therapy with aspirin and a P2Y12 inhibitor is instated post stenting to decrease the incident of ST. Cadaveric organ availability is unpredictable, therefore, discontinuation of antiplatelet medication cannot be optimally timed. Many platelet function point of care tests are used to assess bleeding risk and guide perioperative platelet transfusion. Response to allogenic platelet transfusion to control severe intraoperative bleeding may differ with the antiplatelet drug. DES are now used for endovascular interventions for post-transplant orthotropic heart coronary artery disease, hepatic artery stenosis post liver transplantation, etc. Antiproliferative drugs used in DES are also used for post-transplant immunosuppression.
