Influence of aspirin on early allograft thrombosis and chronic allograft nephropathy following renal transplantation

Abstract

Aspirin reduced the rate of early graft thrombosis of renal transplants in this series but did not improve renal function or graft survival. A trend towards a lower rate of chronic allograft nephropathy was noted with aspirin treatment. These findings require confirmation in a prospective randomized trial.

The effect of heparin on graft thrombosis in pediatric renal allografts

“…Some centres have selected aspirin as their preventative therapy [14,15]. A retrospective analysis of 475 adult renal transplant recipients between 1985 and 1991 and from 1991 to 1997 (aspirin prophylaxis was introduced in 1991) [14] showed a significant reduction in RVT from 5.6% to 1.2% in those who received low-dose aspirin prophylaxis.…”

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“…Aspirin was shown to reduce the rate of early graft thrombosis; however, it did not improve graft function or survival. 15 Grotz and associates showed that lowdose aspirin therapy improved graft function and survival. 17 However, their study had a significant limitation; the mean time to start of aspirin was 2.64 years after transplant, and aspirin therapy only covered 50% of the overall graft survival time.…”

“…Also the immunosuppressive regimen in that study was cyclosporine, and patients did not receive induction therapy with basiliximab or antithymocyte globulin. 15 In our study, recent immunosuppressive protocols were used; all patients received induction therapy with basiliximab or antithymocyte globulin, and most patients were on tacrolimus as maintenance therapy. Aspirin was started from day 1 posttransplant, and long-term therapy covered the whole period analyzed posttransplant.…”

“…11 They promote plaque growth and mediate the inflam matory process of plaque formation. [12][13][14][15] Aspirin has been effective in preventing coronary artery diseases 18,19 by inhibiting platelet aggregation through the irreversible blocking of cyclooxygenase 1. [18][19][20] Therefore, it can be hypothesized that longterm low-dose aspirin therapy could have a protective effect against IFTA and promote graft function and survival.…”

“…11,12 Some studies have shown that aspirin decreases the severity of kidney ischemia-reperfusion injury and the development of tubular atrophy in animal models. [13][14][15] The pathogenic mechanisms of chronic allograft dysfunction is similar to those involved in coronary artery diseases, and aspirin has shown great benefits in coronary artery disease. 1,10,11 Few studies have demonstrated the potential role of mammalian target of rapamycin inhibitors in stabilizing atherosclerotic plaques and hence prevention of coronary artery diseases.…”