• Omeed Elboudwarej, Jignesh K Patel, Frank Liou, Matthew Rafiei, Ashley Osborne, Wanxing Chai, Michelle Kittleson, Lawrence Czer, Lily Stern, Fardad Esmailian, and Jon A Kobashigawa.
• Cedars-Sinai Heart Institute, Los Angeles, CA, USA.
• Clin Transplant. 2015 Jul 1; 29 (7): 629-35.

IntroductionHeart transplant patients have risk factors that place them at higher risk for acute venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), than the general population. We assessed for rate of VTE and incidence of PE-related mortality among heart transplant patients.Materials And MethodsA total of 1258 heart transplant patients were evaluated for the development of VTE. The diagnosis of DVT was made by Duplex ultrasonography, and PE was diagnosed by computerized tomography pulmonary angiography or ventilation-perfusion radionuclide scan. PE-related mortality was assessed at one yr, three yr, and five yr post-transplant.ResultsA total of 117 (9.3%) patients were diagnosed with DVT, including 65 of 117 (55.5%) with lower extremity DVT (LEDVT) and 52 of 117 (44.4%) with upper extremity DVT (UEDVT). A total of 24 (1.9%) patients experienced PE with seven (29.2%) resulting deaths. The rate of LEDVT and UEDVT was similar (55.5% vs. 44.4%); however, the incidence of PE was greater for those with LEDVT (23.1% vs. 7.7%; p = 0.04). Patients with PE had lower survival over the five-yr follow-up period compared to those with DVT only (67% vs. 81%; p = 0.51).ConclusionHeart transplant patients have a high incidence of VTE despite current best practice, indicating a need for a more aggressive approach to thromboprophylaxis.© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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