Deep venous thrombosis after renal transplantation

Area of Science:

• Nephrology
• Vascular Surgery
• Transplantation Medicine

Background:

• Deep venous thrombosis (DVT) and pulmonary embolism (PE) are significant risks following renal transplantation.
• Understanding the incidence and risk factors for these events is crucial for patient management.

Purpose of the Study:

• To determine the incidence of DVT and PE in adult renal transplant recipients.
• To identify risk factors and optimal timing for thrombotic event prophylaxis.

Main Methods:

• Retrospective review of 480 consecutive adult renal transplant operations over ten years.
• Strict diagnostic criteria were used to identify thrombotic events (DVT, PE, or both).
• Analysis of patient demographics, clinical factors, and medications associated with thrombotic events.

Main Results:

• A total of 40 thrombotic events (8.3%) were diagnosed, including DVT alone, DVT with PE, and PE alone.
• Pulmonary embolism (PE) was the fourth leading cause of death during the study period.
• Peak incidence of thrombotic events occurred four months post-transplant, associated with increased hemoglobin levels.
• Significant risk factors included patient age, prolonged bedrest, further surgery, and pelvic pathology.
• Steroid use was universal in the thrombotic group; no events occurred in patients on cyclosporin alone.

Conclusions:

• Chemical prophylaxis for DVT/PE is indicated for renal transplant patients over 40, with stable renal function, on steroids, and experiencing prolonged bedrest or further surgery.
• The findings suggest a potential link between increased hemoglobin and thrombotic events post-transplantation.
• Further research into prophylactic strategies tailored to specific risk profiles is warranted.