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Primary renal graft thrombosis

N Bakir1, W J Sluiter, R J Ploeg

  • 1Department of Internal Medicine, University Hospital Groningen, The Netherlands.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|January 1, 1996
PubMed
Summary

Primary renal graft thrombosis, a significant cause of kidney transplant loss, occurs in 6% of cases. Key risk factors include donor kidney laterality, recipient history of venous thrombosis, diabetic nephropathy, surgical issues, and hemodynamic instability.

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Area of Science:

  • Nephrology
  • Transplantation Surgery
  • Vascular Surgery

Background:

  • Renal allograft thrombosis is a critical complication leading to graft loss, often with unclear etiology beyond rejection.
  • The incidence and risk factors for graft thrombosis without rejection evidence require further elucidation.

Purpose of the Study:

  • To determine the incidence of primary renal graft thrombosis (PRGT) in kidney transplant recipients.
  • To identify independent risk factors associated with PRGT.
  • To explore the relationship between PRGT and other thrombotic events.

Main Methods:

  • Retrospective analysis of 558 consecutive cadaveric kidney transplants.
  • Identification of graft thrombosis cases lacking histopathological evidence of rejection.

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  • Univariate and multivariate analyses to identify risk factors and associated morbidities.

    • Main Results:

    • The incidence of PRGT was 6%, contributing significantly to early and 1-year graft losses.
    • Independent risk factors identified: donor's right kidney, recipient's history of venous thrombosis, diabetic nephropathy, technical surgical problems, and perioperative hemodynamic status.
    • PRGT was associated with delayed graft function and extrarenal thromboembolic manifestations.

    Conclusions:

    • Primary renal graft thrombosis is a significant contributor to kidney allograft loss.
    • High-risk patients require effective prophylactic strategies to prevent thrombosis.
    • Associated extrarenal thrombosis highlights the systemic nature of the risk.