Frequency, Potential Risk and Therapeutic Intervention in Esrd Patients With Antiphospholipid Antibody Syndrome - A Multicenter Study.

Vaidya, SJ; Sellers, Rachel; Kimball, Pamela; Shanahan, Thomas G.; Gugliuzza, Kristene; Fish, Jay C.

doi:10.1097/00007890-199904150-00619

Cited by 4 publications

(12 citation statements)

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“…These include antithrombin III deficiency, known for over 30 years, as well as deficiencies in protein C and protein S. Although these deficiencies are rare, factor V Leiden and prothrombin G20210 mutations are fairly common (6). Acquired coagulation defects are particularly common in patients with end‐stage renal disease (7–9). The prevalence of antiphospholipid antibodies in patients awaiting renal transplantation is more than 10% (7).…”

Section: Introductionmentioning

confidence: 99%

Management of Thrombophilia in Renal Transplant Patients

Morrissey

Ramírez

Gohh

et al. 2002

American Journal of Transplantation

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Renal allograft recipients with thrombophilia (a hypercoagulable state) are at higher risk for early allograft loss. Following an episode of allograft renal vein thrombosis in a patient subsequently diagnosed with protein C deficiency, we adopted universal screening for hypercoagulable risk factors. Patients with a history of a thromboembolic event underwent laboratory screening for thrombophilia. Eight patients with a defined hypercoagulable disorder or a strong clinical history of thrombosis even in the absence of hematologic abnormalities were treated with anticoagulation following renal transplantation. We reviewed the outcomes of these eight patients and all renal transplant recipients at our center who developed thrombotic complications after renal transplantation. Since the introduction of universal screening for hypercoagulable risk factors, 235 consecutive transplants were performed without allograft thrombosis. Eight patients with evidence of thrombophilia, recognized before renal transplantation, received perioperative heparin and postoperative oral anticoagulation. Two of these eight patients developed perinephric hematomas requiring evacuation, blood transfusion, and temporary withholding of anticoagulation. Of interest, two of the remaining 227 patients, not identified with thrombophilia before surgery, developed thrombotic complications after renal transplantation. A hypercoagulable disorder was subsequently documented in each. Identifying patients with thrombophilia before transplantation and defining their management presents many challenges. The risk of allograft thrombosis must be weighed against the risk of perioperative bleeding and the need for long-term anticoagulation. Recommendations for managing thrombophilia in renal transplant recipients are suggested based on our experience and review of the literature.

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Section: Introductionmentioning

confidence: 99%

Management of Thrombophilia in Renal Transplant Patients

Morrissey

Ramírez

Gohh

et al. 2002

American Journal of Transplantation

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“…Although several studies showed that acquired coagulation defects are particularly common in patients with ESRD [27,28], others found that patients with thrombophilic disorders have no increased risk of progression to ESRD compared with nonthrombophilic individuals [29]. Further studies should focus on assessing the role of hemostatic alterations in the pathogenesis of ESRD.…”

Section: Discussionmentioning

confidence: 99%

Thrombophilic disorders

Klai

Fekih-Mrissa²,

Ghachem³

et al. 2012

Blood Coagulation &Amp; Fibrinolysis

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Management of end-stage renal disease is the mainstay of prevention of renal vascular complications and kidney rejection. We sought to describe the association of some disorders such as diabetic nephropathy, polycystic renal disease, hypertension, and thrombophilia with renal failure and discuss possible mechanisms explaining the implication of the thrombophilic states in kidney allograft thrombosis and renal rejection. Five hundred and sixty-eight patients were included in this case-control study and multivariate analysis was applied. Cases and controls were tested for all major types of thrombophilia. Diabetic nephropathy, autosomal dominant polycystic kidney disease, hypertension, and smoking are the strongest causal agents of end-stage renal disease in Tunisia. It should also be noted that the prevalence of factor V Leiden (P = 0.05) and protein C deficiency (P = 0.005) were significantly higher in ESRD patients awaiting renal transplantation than controls. The present study has raised the possibility that thrombophilic factors may play a pathophysiological role in renal failure. These results will serve as a basis for anticoagulant prophylaxis aimed at preventing kidney rejection and renal allograft thrombosis.

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“…All seven with APAS who underwent transplantation without anticoagulation had graft thrombosis, while grafts survived in three of four with APAS who received anticoagulation (998). None of the 37 patients with high antiphospholipid antibody titers without APAS lost their allografts as a result of thrombosis (998).…”

Section: Coagulopathiesmentioning

confidence: 96%

“…In a recent study, 19% of 502 patients awaiting renal transplantation had antiphospholipid antibodies (998). There were 23 patients with APAS (998). All seven with APAS who underwent transplantation without anticoagulation had graft thrombosis, while grafts survived in three of four with APAS who received anticoagulation (998).…”

Section: Coagulopathiesmentioning

confidence: 99%

See 1 more Smart Citation

The Evaluation of the Renal Transplant Candidates: Clinical Practice Guidelines

2001

American Journal of Transplantation

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Frequency, Potential Risk and Therapeutic Intervention in Esrd Patients With Antiphospholipid Antibody Syndrome - A Multicenter Study.

Cited by 4 publications

References 0 publications

Management of Thrombophilia in Renal Transplant Patients

Management of Thrombophilia in Renal Transplant Patients

Thrombophilic disorders

The Evaluation of the Renal Transplant Candidates: Clinical Practice Guidelines

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