Background Antiplatelet therapy is common in patients on the waiting list for kidney transplantation increasing the risk for perioperative blood loss. This study evaluates the incidence of postoperative bleeding in patients undergoing kidney transplantation with concomitant antiplatelet therapy and analyzes the impact on the outcome.

Methods We conducted a single center study including all patients undergoing kidney transplantation with concomitant antiplatelet therapy (January 2007 to June 2012). Data were collected prospectively. Subjects with postoperative bleeding complications were identified by chart review. Univariable and multivariable logistic regression and cox proportional hazards were performed to identify risk factors for the outcome.

Results Among 744 kidney transplant patients, 161 (n=98 male, 60.9%) received oral antiplatelet therapy and were included in the study. Median age of the recipients was 61 (30-77) years. One third of patients demonstrated signs of bleeding posttransplant requiring surgical treatment (18%). Coronary artery disease, deceased donor kidney transplantation and dual antiplatelet medication were identified as independent risk factors for postoperative bleeding. Postoperative bleeding was identified as an independent risk factor for graft and patient survival. One-year allograft survival in the non-bleeding group was significantly better than in the bleeding group (91.4% vs. 75.9%, p =0.023),respectively.

Conclusion This analysis indicates a high risk for bleeding in renal transplant patients under antiplatelet therapy. The associated negative effect on the outcome underscores the need to reduce any risk factor for postoperative bleeding.

CITATION INFORMATION: Benko T, Gottmann M, Radunz S, Treckmann J, Saner F, Paul A, Hoyer D. Renal Transplant Recipients with Indication for Antiplatelet Therapy: Increased Risk for the Allograft? Am J Transplant. 2017;17 (suppl 3).

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