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The effect of aspirin on kidney allograft outcomes; a short review to current studies

Wisit Cheungpasitporn1, Charat Thongprayoon1, Donald G Mitema1

  • 1Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.

Journal of Nephropathology
|October 5, 2017
PubMed

Insights

Aspirin use in kidney transplant recipients significantly lowers the risk of allograft failure, thrombosis, and major adverse cardiac events or mortality. However, it does not impact allograft rejection or delayed graft function, and bleeding risks require further study.

Area of Science:

  • Nephrology
  • Cardiology
  • Transplantation Medicine

Background:

  • Aspirin use in chronic kidney disease (CKD) patients is linked to reduced myocardial infarction but increased bleeding risk.
  • The specific impact of aspirin on kidney transplant recipients remains unclear.

Purpose of the Study:

  • To evaluate the efficacy and safety of aspirin in kidney transplant recipients.
  • To assess aspirin's effects on allograft outcomes, major adverse cardiac events (MACEs), mortality, and bleeding risk.

Main Methods:

  • A comprehensive literature search was conducted across major databases (MEDLINE, EMBASE, Cochrane) up to September 2016.
  • Included studies reported risk ratios or hazard ratios for aspirin use in kidney transplant recipients.
  • Pooled risk ratios (RR) with 95% confidence intervals (CI) were calculated using a random-effect model.

Main Results:

  • The meta-analysis included 9 studies with 19,759 kidney transplant recipients.
  • Aspirin significantly reduced the risk of allograft failure (RR: 0.57), allograft thrombosis (RR: 0.11), and MACEs or mortality (RR: 0.72).
  • No significant effect was observed on allograft rejection (RR: 0.86) or delayed graft function (DGF) (RR: 1.00); bleeding risk data were limited.

Conclusions:

  • Aspirin administration in kidney transplant recipients is associated with decreased risks of allograft failure, thrombosis, and MACEs/mortality.
  • Aspirin does not appear to affect allograft rejection or DGF.
  • Further research is necessary to fully evaluate bleeding risks and establish the overall risk-benefit profile of aspirin in this population.
Abstract

Keywords:
Allograft failureAspirinDelayed graft functionKidney transplantationTransplantation

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