Safety of liver resection in patients receiving antithrombotic therapy: A systematic review of the literature

Table 3 Reported data concerning the safety of thromboprophylaxis for venous thromboembolism during liver resection

Ref.	Year, type	Surgery type	Drug use and exposure	Bleeding events	TE, mortality
Ainoa et al[15]	2020, RCS	Liver resection (n = 512)	Patients with preop TP (n = 253); Patients with postop TP (control, n = 259)	BC 15.0% in preop TP vs 13.9% in control (P > 0.05)	VTE 1.2% vs 9.7% (P < 0.0001); PE 1.2% vs 9.3% (P < 0.0001)
Ejaz et al[16]	2014, RCS	Liver resection (n = 599)	Patients with TP (n = 454); Patients without TP (control, n = 145)	Not mentioned	VTE 5.1% in TP vs 3.4% in control (P = 0.42)
Nathan et al[17]	2014, RCS	Liver resection (n = 2147)	Patients with early TP (n = 1295); Patients with late or no TP (control, n = 852)	Major BC 1.7% in early TP vs 1.6% in control (P > 0.05)	VTE 2.1% vs 3.3% (P > 0.05); Overall mortality 1.9%
Eguchi et al[18]	2020, mPCS	Major HBP surgery (n = 133) including 74 liver resection	Patients with TP [LMWH (enoxaparin), n = 133, single arm]	Major BC 2.3%; Minor BC 5.2%	No PE event in whole cohort
Hayashi et al[19]	2014, RCS	Major HBP surgery (n = 349) including 138 liver resection	Patients with TP (n = 207); Patients without TP (control, n = 142)	BC 26.6% in TP vs 8.5% in control (P < 0.05); Rate of major BC is identical	VTE 2.9% vs 7.7% (P > 0.05)
Wang et al[20]	2018, CCS	Liver resection (n = 233)	Patients with TP (LMWH, n = 117); Patients without TP (control, n = 116)	Not mentioned	VTE 0.85% in TP vs 13.8% (P < 0.05)
Kim et al[21]	2017, RCS	Liver resection (n = 124)	Patients with extended TP [LMWH (enoxaparin), n = 124, single arm]	BC 1.6% in extended TP	No VTE in whole cohort
Doughtie et al[22]	2014, RCS	Major HBP surgery (n = 223) including 110 liver resection	Patients with preop TP (LMWH, n = 93); Patients without preop TP (control, n = 130)	Major BC 10.9% in preop TP vs 3.1% in control (P = 0.026); SBL was identical	VTE 1.1% vs 6.1% (P = 0.05)
Melloul et al[23]	2012, RCS	Liver resection (n = 410)	Patients with TP (n = 410, single arm)	Not mentioned	PE 6% (24/410) in TP
Reddy et al[24]	2011, RCS	Major liver resection (n = 419)	Patients with TP (n = 275); Patients without TP (control, n = 144)	RBC transfusion rate 35.0% in TP vs 30.6% in control (P = 0.36)	CR-VTE 2.2% in TP vs 6.3% in control (P = 0.03); PE 2.2% vs 4.2% (P = 0.35)

mRCT: Multicenter randamized controlled trial; RCS: Retrospective cohort study; mRCS; multicenter retrospective cohort study; LMWH: Low-molecular-weight heparin; TP: Thromboprophylaxis; LAP: Laparoscopic; CR: Clinically relevant; BC: Postoperative bleeding complication; VTE: Venous thromboembolism; PE: Pulmonary embolism; AOR: Adjusted odds ratio.