Acquired hypercoagulable state in renal transplant recipients

Kazory, Amir; Ducloux, Didier

doi:10.1160/th03-09-0568

Cited by 50 publications

(10 citation statements)

References 98 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Many reports have been published on clotting alterations in patients with renal disease; the increased risk of thrombotic events is multifactorial and is related to specific conditions of RT. Alterations of hemostasis have been demonstrated in relation to the immunosuppressive treatment used in these patients, in particular to calcineurin inhibitors [5]. In addition, the occurrence of acute CMV infection is reported as a risk factor for the occurrence of VTE [5].…”

Section: Discussionmentioning

confidence: 99%

“…Thromboembolism is strongly correlated with the surgery procedure. However, it is well known that in RT patients there is an imbalance of the hemostatic system, leading to a persistent hypercoagulable state [1][2][3][4][5] that may play a role in later events. The nature of clotting activation is probably multifactorial, in part owing to classic risk factors, in part owing to specific factors related to RT.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Renal transplant recipients are at high risk for both symptomatic and asymptomatic deep vein thrombosis

Poli

Zanazzi

Antonucci

et al. 2006

Journal of Thrombosis and Haemostasis

View full text Add to dashboard Cite

Summary. Background: Venous thromboembolism (VTE) is one of the thrombotic complications that can occur in patients receiving renal transplantation (RT). The prevalence of VTE in RT patients is, however, undefined. Objectives: To evaluate the rate of a first episode of VTE in a series of 538 consecutive RT recipients admitted to our institution, the timing of occurrence of the thromboembolic events after transplantation, and the rate of recurrence after thromboprophylaxis withdrawal. Risk factors for recurrence were also evaluated, particularly in relation to the type of the first event (symptomatic or asymptomatic). Results: During follow-up, 47 of 518 patients (28 males, 19 females; 9.1%) developed a first episode of VTE at a median time of 17 months (range 1-165 months) after kidney transplantation. Cancer was associated with the occurrence of VTE (odds ratio 4.8). Seventeen of 43 patients (39.5%) with deep vein thrombosis were asymptomatic and the diagnosis was made during routine ultrasound examination. Twenty-two patients (46.8%) experienced a recurrence of VTE. A relevant rate of recurrence was documented amongst patients with a first episode of both symptomatic (53%) and asymptomatic (23.5%) VTE. Conclusion: This study confirms that RT patients are at high risk of symptomatic and asymptomatic VTE and that this risk persists even after several years. Patients who experience VTE are at high risk of recurrence after thromboprophylaxis withdrawal.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Renal transplant recipients are at high risk for both symptomatic and asymptomatic deep vein thrombosis

Poli

Zanazzi

Antonucci

et al. 2006

Journal of Thrombosis and Haemostasis

View full text Add to dashboard Cite

show abstract

“…10 However, relatively little information is available regarding the risk of VTE and the optimal approach to VTE prevention among individuals undergoing hematopoietic stem cell transplantation (HSCT). 11 Patients undergoing HSCT have a number of identifiable risk factors for VTE, including prolonged hospitalization, indwelling vascular catheters, exposure to cytotoxic chemotherapy and immune modulators, [12][13][14][15][16] infections, 17 and graft-versus-host disease (GVHD). 18,19 However, perhaps even more so than other patients with hematologic malignancies, patients undergoing HSCT also face an increased risk of bleeding.…”

Section: Introductionmentioning

confidence: 99%

The incidence of and risk factors for venous thromboembolism (VTE) and bleeding among 1514 patients undergoing hematopoietic stem cell transplantation: implications for VTE prevention

Gerber

Segal

Levy³

et al. 2008

Blood

134

112

View full text Add to dashboard Cite

Venous thromboembolism (VTE) is increasingly diagnosed among individuals with hematologic malignancies. However, the risk of VTE among patients undergoing hematopoietic stem cell transplantation (HSCT) is unclear. We examined the incidence and risk factors for VTE and bleeding among 1514 patients undergoing in-patient HSCT. No protocolized VTE prophylaxis was used. By HSCT day 180, 75 symptomatic VTE occurred in 70 patients (4.6%; 95% confidence interval [CI], 3.6%-5.8%). Fifty-five (3.6%) were catheterassociated, 11 (0.7%) were non-catheterassociated deep venous thromboses, and 9 (0.6%) were pulmonary emboli. Thirtyfour percent of VTE occurred at a platelet count less than 50 ؋10 9 /L; 13% occurred at a platelet count less than 20 ؋10 9 /L. In multivariate analysis, VTE was associated with prior VTE (odds ratio [OR], 2.9; 95% CI, 1.3-6.6) and with graft-versushost disease (GVHD; OR, 2.4; 95% CI, 1.4-4.0). Clinically significant bleeding occurred in 230 patients (15.2%; 95% CI, 13.4%-17.1%); 55 patients (3.6%; 95% CI, 2.7%-4.7%) had fatal bleeding. Bleeding was associated with anticoagulation (OR, 3.1; 95% CI, 1.8-5.5), GVHD (OR, 2.4; 95% CI, 1.8-3.3), and veno-occlusive disease (OR, 2.2; 95% CI, 1.4-3.6). In HSCT patients, VTE is primarily catheter-related and 3-fold less common than clinically significant bleeding. These findings warrant consideration when selecting VTE prophylaxis in HSCT patients. (Blood. 2008;112:504-510)

show abstract

“…6 It occurs possibly due to impaired fibrinolysis and a persistent hypercoagulable state. 7 In 1 of our patients, a pulmonary embolism developed as a consequence of deep venous thrombosis.…”

Section: Discussionmentioning

confidence: 80%

Untitled

2016

Exp Clin Transplant

View full text Add to dashboard Cite

Objectives: Patients who are being considered for renal transplant must undergo thorough preoperative pulmonary evaluation to determine risk of postoperative pulmonary complications. The aim of this study was to determine the relation between the preoperative pulmonary risk factor score and pulmonary complications in patients undergoing renal transplant. Materials and Methods: Medical records of patients who underwent renal transplant at our institution between 2004 and 2015 were retrospectively reviewed. Patient demographics, smoking history, comorbidities, and preoperative pulmonary risk factors (age, oxygen saturation, hemoglobin level, type of incision, duration of surgery, history of lower respiratory tract infection 1 month before surgery, urgency of surgery), and type of pulmonary complications within 1 month after transplant were recorded. Results: Our study included 131 patients (94 male patients; mean age of 38.25 ± 12.96 y). Of total patients, 21(16%) developed complications during the first month after transplant, with 10 of the 21 (7.6% overall) developing pulmonary complications. These complications were pleural effusion (2 patients), pneumonia (3 patients), respiratory failure (2 patients), and pulmonary embolism (1 patient). There were no deaths directly attributed to the pulmonary complications. A significant correlation was observed between the preoperative pulmonary risk factor score and postoperative pulmonary complications in renal transplant recipients (P = .003). A positive correlation between the preoperative pulmonary scores and postoperative pulmonary complications existed among life-long nonsmokers (r = 0.371; P = .003). Conclusions: Renal transplant is an established modality in treatment of chronic renal failure. Prevention of pulmonary complications is essential for successful outcomes following transplant. Health care professionals involved with renal transplant and transplant centers should be aware of preoperative pulmonary risk factors. Patients should be observed so that these risk factors can be reduced before planned transplant. Moreover, we also suggest that smoking history should be considered as a preoperative pulmonary risk factor as it was found to be a factor leading to postoperative pulmonary complications in our study.

show abstract

Acquired hypercoagulable state in renal transplant recipients

Cited by 50 publications

References 98 publications

Renal transplant recipients are at high risk for both symptomatic and asymptomatic deep vein thrombosis

Renal transplant recipients are at high risk for both symptomatic and asymptomatic deep vein thrombosis

The incidence of and risk factors for venous thromboembolism (VTE) and bleeding among 1514 patients undergoing hematopoietic stem cell transplantation: implications for VTE prevention

Untitled

Contact Info

Product

Resources

About