Current practice of antithrombotic prophylaxis in pediatric kidney transplantation—Results of an international survey on behalf of the European Society for Paediatric Nephrology

Buder, Kathrin; Zirngibl, Matthias; Bapistella, Sascha; Nadalin, Silvio; Tönshoff, Burkhard; Weitz, Marcus

doi:10.1111/petr.13799

Cited by 11 publications

(10 citation statements)

References 35 publications

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“…Nevertheless, the majority of KTx professionals prefer to use some form of perioperative thromboprophylaxis, even though evidence-based recommendations are lacking. UFH appears to be the most favored thromboprophylactic agent for intraoperative use, possibly due to its beneficial pharmacokinetic characteristics, such as a low half-life and the fact that it is not eliminated by the kidney [ 11 , 12 ]. Dosing however varied considerably between 400 and 10,000 IU.…”

Section: Discussion/conclusionmentioning

confidence: 99%

Antithrombotic Management in Adult Kidney Transplantation: A European Survey Study

et al. 2021

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In kidney transplantation (KTx), renal graft thrombosis (RGT) is one of the main reasons for early graft loss. Although evidence-based guidance on prevention of RGT is lacking, thromboprophylaxis is widely used. The aim of this survey was to obtain a European view of the different thromboprophylactic strategies applied in KTx. An online 22-question survey, addressed to KTx professionals, was distributed by e-mail and via platforms of the European Society for Organ Transplantation. Seventy-five responses (21 countries, 51 centers) were received: 75% had over 10 years’ clinical experience, 64% were surgeons, 29% nephrologists and 4% urologists. A written antithrombotic management protocol was available in 75% of centers. In 8 (16%) of centers respondents contradicted each other regarding the availability of a written protocol. Thromboprophylaxis is preferred by 78% of respondents, independent of existing antithrombotic management protocols. Ninety-two percent of respondents indicated that an anticipated bleeding risk is the main reason to discontinue chronic antithrombotic therapy preoperatively. Intraoperatively, 32% of respondents administer unfractionated heparin (400 – 10.000 international units with a median of 5000) in selected cases. Despite an overall preference for perioperative thromboprophylaxis in KTx, there is a high variation within Europe regarding type, timing and dosage, most likely due to the paucity of high-quality studies. Further research is warranted in order to develop better guidelines.

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Section: Discussion/conclusionmentioning

confidence: 99%

Antithrombotic Management in Adult Kidney Transplantation: A European Survey Study

et al. 2021

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“…[9][10][11] In the absence of evidence-based recommendations and consensus guidelines, current antithrombotic strategies are often characterized by incongruent, non-standardized, and center-specific protocols for aP. 12,13 Therefore, this systematic review and meta-analysis were performed to collate, summarize, and quantify the available evidence on beneficial and adverse effects of aP in adult and pediatric KTx recipients.…”

Section: Introductionmentioning

confidence: 99%

“…In the absence of evidence‐based recommendations and consensus guidelines, current antithrombotic strategies are often characterized by incongruent, non‐standardized, and center‐specific protocols for aP 12,13 …”

Section: Introductionmentioning

confidence: 99%

Prophylactic antithrombotic management in adult and pediatric kidney transplantation: A systematic review and meta‐analysis

Bapistella

Zirngibl

Buder

et al. 2021

Pediatric Transplantation

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“…Even though studies show conflicting results toward the beneficial effects for prevention of renal graft thrombosis, a recent publication of a survey done in 80 pediatric kidney transplant centers from 37 countries showed that antithrombotic prophylaxis was performed in 96% of the pediatric renal transplant centers 17 …”

Section: Introductionmentioning

confidence: 99%

Thromboprophylaxis after kidney transplantation in children: Ten‐year experience of a single Brazilian center

Beatrice

Takahashi²,

Celeste

et al. 2021

Pediatric Transplantation

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Background Kidney transplantation is the gold standard treatment for children with end‐stage chronic kidney disease. Graft thrombosis is an important cause of graft failure, with high morbidity, mortality, and impact on quality of life and to the health system. The role of thromboprophylaxis in this setting is still uncertain. We describe the demographic characteristics and thrombotic risk factors in pediatric renal transplant recipients, determining the rate of renal graft thrombosis, and discuss the role of thromboprophylaxis. Methods This retrospective study reviewed 96 pediatric renal transplantations between 2008 and 2017 in a single hospital. Patients were assigned to one of two groups: children who did not receive thromboprophylaxis after transplantation and those who did. We reported their characteristics, comparing the incidence of graft thrombosis and hemorrhagic complications between the groups. Results Forty‐nine patients (51%) received thromboprophylaxis. Thrombosis occurred in 5 patients who did not receive thromboprophylaxis (5.2%) compared with none in the group that did (p = .025). In all patients, renal graft thrombosis resulted in early graft loss. Thirteen patients had hemorrhagic complications. Seven were unrelated to pharmacological thromboprophylaxis (2 major, 1 moderate, and 4 minor bleeding, which either did not receive thromboprophylaxis or had bleeding prior to thromboprophylaxis), while six occurred during heparinization (2 major, 1 moderate, and 3 minor bleeding). There was no significant difference in the rate of hemorrhagic complications between the groups (p = .105). Conclusions The rate of renal graft thrombosis was 5.2%. Thrombosis remains an important cause of early graft loss. Thromboprophylaxis was associated with a reduction in graft thrombosis without increased risk of bleeding.

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Current practice of antithrombotic prophylaxis in pediatric kidney transplantation—Results of an international survey on behalf of the European Society for Paediatric Nephrology

Abstract: Members of the "Transplantation Working Group" of the European Society for Paediatric Nephrology (ESPN)* * Collaborators including physicians who completed the survey are listed at the end of this article.

Cited by 11 publications

References 35 publications

Antithrombotic Management in Adult Kidney Transplantation: A European Survey Study

Antithrombotic Management in Adult Kidney Transplantation: A European Survey Study

Prophylactic antithrombotic management in adult and pediatric kidney transplantation: A systematic review and meta‐analysis

Thromboprophylaxis after kidney transplantation in children: Ten‐year experience of a single Brazilian center

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