Key result
Administration of 5g of idarucizumab to reverse dabigatran prior to liver transplantation was followed by an intraoperative myocardial infarction in a 66-year-old male with cirrhosis.
Case Report (n=1)
Idarucizumab administration for dabigatran reversal prior to liver transplantation may be associated with a risk of intraoperative myocardial infarction.
Single case supports idarucizumab reversal before liver transplant on dabigatran; hypothesis-generating and requires prospective confirmation in cirrhosis.
Insufficient information is available regarding the administration of anticoagulants, specifically direct oral anticoagulants, in individuals with cirrhosis awaiting liver transplantation. In this report, we present a case of a 66-year-old male with atrial fibrillation treated with dabigatran who received idarucizumab prior to orthotopic liver transplantation. Hemostatic status was monitored throughout the procedure with both conventional hemostatic tests and point-of-care viscoelastic hemostatic assays. The patient suffered an intraoperative myocardial infarction, which could be related to the use of idarucizumab.
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Barroso et al. (2023) conducted a case report in End-stage liver disease and atrial fibrillation (n=1). Idarucizumab was evaluated on Intraoperative myocardial infarction. Administration of 5g of idarucizumab to reverse dabigatran prior to liver transplantation was followed by an intraoperative myocardial infarction in a 66-year-old male with cirrhosis.
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