Risk Factors for Early Renal Graft Thrombosis: A Case-Controlled Study in Grafts From the Same Donor

Amézquita, Yésika; Mendez, Carla; Fernandez, Armida; Caldés, Silvia; Pascual, Julio; Muriel, Alfonso; Burgos, Francisco; Marcén, R.; Ortuño, J

doi:10.1016/j.transproceed.2008.09.014

Cited by 28 publications

(38 citation statements)

References 8 publications

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“…The cases were individually matched with two controls from the same year and the same transplantation center. The third case-control study is from a single center with the contralateral kidney as the only control [25]; the thrombosis case was solely included when the other kidney was transplanted in the same center thus leading to many exclusions and only 24 of 42 (57%) cases available for analysis.…”

Section: Incidence Of Vascular Thrombosismentioning

confidence: 99%

Identification of Risk Factors for Vascular Thrombosis May Reduce Early Renal Graft Loss: A Review of Recent Literature

Keller

Jørgensen

Jespersen

2012

Journal of Transplantation

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Renal graft survival has improved over the past years, mainly owing to better immunosuppression. Vascular thrombosis, though rare, therefore accounts for up to one third of early graft loss. We assess current literature on transplantation, identify thrombosis risk factors, and discuss means of avoiding thrombotic events and saving thrombosed grafts. The incidence of arterial thrombosis was reported to 0.2–7.5% and venous thrombosis 0.1–8.2%, with the highest incidence among children and infants, and the lowest in living donor reports. The most significant risk factors for developing thrombosis were donor-age below 6 or above 60 years, or recipient-age below 5-6 years, per- or postoperative hemodynamic instability, peritoneal dialysis, diabetic nephropathy, a history of thrombosis, deceased donor, or >24 hours cold ischemia. Multiple arteries were not a risk factor, and a right kidney graft was most often reported not to be. Given the thrombosed kidney graft is diagnosed in time, salvage is possible by urgent reoperation and thrombectomy. Despite meticulous attentions to reduce thrombotic risk factors, thrombosis cannot be entirely prevented and means to an early detection of this complication is desirable in order to save the kidneys through prompt reoperation. Microdialysis may be a new tool for this.

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Section: Incidence Of Vascular Thrombosismentioning

confidence: 99%

Identification of Risk Factors for Vascular Thrombosis May Reduce Early Renal Graft Loss: A Review of Recent Literature

Keller

Jørgensen

Jespersen

2012

Journal of Transplantation

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“…On this basis, they further suggested for prophylactic anticoagulation or platelets antiaggregation therapy for right donor kidney implantation [9].…”

Section: Discussionmentioning

confidence: 99%

Renal Allograft Thrombosis in the Early Post Transplant Period

Budruddin¹,

Salmi²,

Shilpa³

2013

OJNeph

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Renal allograft thrombosis involving either the renal artery or the veins is a well known entity in clinical practice. This complication of the renal transplant surgery is more common in the early part of the post transplant period and it is usually associated with acute antibody mediated rejection. This more commonly occurs in the paediatric renal transplant and also seems to have some relation to the duration of peritoneal dialysis pretransplant. However, the occurrence of graft thrombosis in isolation without clinical or histological graft rejection is not rare. We encountered a patient in whom the renal allograft thrombosis occurred after 6 weeks of commercial renal transplantation without any histological evidence of rejection.

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“…2,[8][9][10][11] Transplant renal vein thrombosis events lead to graft loss and nephrectomy in almost all cases. 5,[12][13][14] The prevalence of TRVT is higher in deceased-donor than in livingdonor transplant. This may be because living-donor transplant procedures are usually done under more favorable conditions and are not usually subjected to ischemic injury.…”

Section: Introductionmentioning

confidence: 99%

“…When considering donor risk factors, use of a donor's right kidney is associated with the development of renal graft thrombosis, 8,9,14,15 due to the short vein and long artery of the right kidney. The short renal vein can be easily compressed pos toperatively by the kidney swelling due to ischemic damage, acute tubular necrosis, or urinary obstruction.…”

Section: Introductionmentioning

confidence: 99%

“…8,9 Multiple graft vessels have been also implicated in renal graft thrombosis in some studies, 15 although refuted in others. 13,14 In addition, prolonged ischemia time 12 and vascular injuries have been found to be donor risk factors for renal graft thrombosis. 13 The prolonged ischemia time could potentiate thrombogenicity of the endothelium, or a resulting acute tubular necrosis with graft edema could lead to decreased perfusion and thrombosis.…”

Section: Introductionmentioning

confidence: 99%

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Zorkany

Bridson²,

Sharma³

et al. 2017

Exp Clin Transplant

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Transplant renal vein thrombosis usually occurs early after surgery with a reported prevalence of 0.1% to 4.2%. It is a devastating event that ultimately leads to graft loss in almost all cases. There are many predisposing factors related to donor, recipient, surgery, and immunosuppression, with mechanical factors being considered the most common causes of transplant renal vein thrombosis. The clinical manifestations of acute renal vein thrombosis are nonspecific and are not dissimilar to the features of urine leak, urinary obstruction, or severe acute rejection. The diagnosis of transplant renal vein thrombosis depends on a high index of clinical suspicion and duplex ultrasonographic scans. Although venography remains the criterion standard, this procedure is invasive and nephrotoxic, due to use of ionizing contrast agents and also due to exposure to ionizing radiation. There are 2 therapies that have been described in the literature for salvaging a renal allograft with transplant renal vein thrombosis: thrombolytic therapy and surgical thrombectomy. The usual end result is renal allograft nephrectomy because the diagnosis is almost always too late.

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Risk Factors for Early Renal Graft Thrombosis: A Case-Controlled Study in Grafts From the Same Donor

Cited by 28 publications

References 8 publications

Identification of Risk Factors for Vascular Thrombosis May Reduce Early Renal Graft Loss: A Review of Recent Literature

Identification of Risk Factors for Vascular Thrombosis May Reduce Early Renal Graft Loss: A Review of Recent Literature

Renal Allograft Thrombosis in the Early Post Transplant Period

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