Introduction Isolated distal deep vein thrombosis (IDDVT) in kidney transplantation recipient (KTR) is difficult to make decision because it is not common in Korean and there are several limitations using anticoagulation; decreased renal function, drug interaction and frequent needs of invasive procedure. We want to share our experience to manage IIDVT in KTR. Methods We have done protocol duplex ultrasound scan (DUS) at before transplantation and postoperatively; 1, 2, 4weeks and 3, 6month. We do venous thromboembolism prophylaxis by gradual compression stocking from operation day to postoperative day 30 and intermittent compression device from operation day to postoperative day 14. We didn't do pharmacologic prophylaxis. A preference of treatment was changed; from 2010 to 2013, we had 'anticoagulation first' strategy and after 2014 we have had 'serial follow-up first' strategy. We choose 'anticoagulation first' strategy in specific case who had large thrombus burden with low bleeding risk. The effect of treatment was determined by follow-up DUS, maintenance of thrombus was considered to need further treatment in early phase but definite extension of thrombus was treated and maintenance of thrombus was observed in late phase. Results During the period, 862 cases of KT was performed and there were 60 cases (6.9%) of DVT. Eleven cases were DVT involved above popliteal vein and 49 cases were IDDVT (81.6%). All cases of IDDVT were asymptomatic. Time of diagnosis was most common during 2weeks and 3 cases were diagnosed later than 3^rd month after KT. Twenty-one patients (42.8%) was treated by 'anticoagulation first' strategy and 28 patients (57.1%) was managed by 'serial follow-up first' strategy. Five patients of 'serial follow-up' first group were taken anticoagulation for maintenance of thrombus on follow-up DUS in early 2014, after then there was no one who needs treatment conversion. Duration of anticoagulation was planned 3month but only fifteen patients completed. Eleven patients stopped early due to bleeding complication, invasive procedure, insufficient graft function and drug interaction. A thrombus extension to proximal deep vein was not observed in both anticoagulation and serial follow-up groups. Conclusion IDDVT in Korean KTR have low incidence and good prognosis and extension to proximal vein is may effectively prevented by mechanical prophylaxis and attentive surveillance.

CITATION INFORMATION: Kim M., Hwang J., Kim S., Park S., Moon I., Kim J. The Incidence and Outcome of Isolated Distal Deep Vein Thrombosis in Kidney Transplant Recipient Am J Transplant. 2017;17 (suppl 3).

« Back to 2018 American Transplant Congress