Venous thromboembolic complications after kidney and kidney-pancreas transplantation: A multivariate analysis

A. Humar, E. M. Johnson, K. J. Gillingham, D. E. Sutherland, W. D. Payne, D. L. Dunn, L. E. Wrenshall, J. S. Najarian, Rainer W G Gruessner, A. J. Matas

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Abstract

Background: We reviewed the incidence of and risk factors for venous thromboembolic complications in our population of kidney (KTx) and simultaneous kidney-pancreas transplant (SPK) recipients. methods: Information was collected retrospectively from a database on 1833 KTx and 276 SPK recipients who underwent transplant surgery between January 1985 and August 1995. Results. The incidence of deep venous thrombosis (DVT) was 6.2%(n = 132), with significantly higher rates after SPK (18.1%) vs. KTx (4.5%) (P<0.001). The number of DVT episodes was highest in the first month; 17.5% occurred during this tine. For KTx recipients, early thrombotic events were more common on the side of the graft (P=0.03); however, after 1 month, no correlation existed between the side of the graft and the side of DVT. For SPK recipients, DVT tended to be more common on the side of the pancreas (57%) vs. the kidney (43%) (P=0.10). By multivariate analysis, risk factors for DVT were: age >40 years (odds ratio [OR]=2.2, P<0.001), diabetes mellitus (DM) (OR=2.0, P=0.002) previous DVT (OR=4.4, P=0.001) and SPK transplant (OR=2.8, P<0.001). Pulmonary embolus (PE) was identified in 44 recipients (incidence, 2.1%) and was fatal in 13 (30%). The incidence was significantly higher in SPK (4.71%) vs. KTx recipients (1.69%) (P<0.01). The risk of death from PE was 0.5% in KTx recipients and 1.37% in SPK recipients (P=0.08). Risk factors for PE included DM (OR=2.6, P=0.005) and recent DVT (OR=8.9, P=0.0001). Conclusions. Based on risk and extrapolating from the general surgical literature, our recommendations for prophylaxis against DVT are use of graduated compression stockings for all recipients and, in addition, low- dose heparin for moderate and high-risk recipients (previous DVT, SPK, age>40 years, DM).

Original languageEnglish (US)
Pages (from-to)229-234
Number of pages6
JournalTransplantation
Volume65
Issue number2
Publication statusPublished - Jan 27 1998
Externally publishedYes

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ASJC Scopus subject areas

  • Transplantation
  • Immunology

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Humar, A., Johnson, E. M., Gillingham, K. J., Sutherland, D. E., Payne, W. D., Dunn, D. L., ... Matas, A. J. (1998). Venous thromboembolic complications after kidney and kidney-pancreas transplantation: A multivariate analysis. Transplantation, 65(2), 229-234.