Date: Sunday, June 12, 2016
Session Name: Poster Session B: Kidney: Cardiovascular and Metabolic
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Introduction: For patients undergoing percutanous coronary intervention (PCI) with drug-eluting stents, dual antiplatelet therapy (DAPT) is often used to prevent stent thrombosis. Kidney transplantation of patients while they are on dual antiplatelet therapy (DAPT), however, can be associated with post-transplant complications, such as bleeding. The safety of transplanting patients on DAPT is unclear.
Methods: We performed a single center, retrospective cohort study of kidney transplant recipients at our center who received a transplant from 2008-2014 and had a pre-transplant diagnosis of coronary artery disease. The medical records were reviewed to determine use of antiplatelet therapy at the time of transplant.
Results: Of the 149 patients, 114 (76.5%) were male, 35 (12.1%) were Black, and 87 (58.4%) had diabetic kidney disease. 21 (14.1%) were not receiving maintenance dialysis at the time of transplant. 97 (65.1%) had at least 1 PCI, while 46 (30.9%) had a coronary artery bypass graft. 78 (52.4%) received a living donor kidney transplant, and the remainder received a deceased donor kidney transplant. 102 (68.5%) were on aspirin pre-transplant and 53 (35.6%) were on aspirin within 3 days of transplant surgery. 64 (43.0%) were on clopidogrel pre-transplant and 39 (26.2%) were on clopidogrel within 3 days of transplant. 66 (44.3%) were on DAPT at the time of transplant. Only 5 (3.4%) were on warfarin at the time of transplant. Overall, patients on DAPT at the time of transplant recipient were more likely to require transfusions. At 1 year, in patients who had been receiving (vs. not receiving) DAPT at the time of transplant, patient survival, rates of kidney transplant biopsy, and cardiovascular readmission were similar, but allograft survival was less.
|On DAPT at transplant||Not on DAPT at transplant||P|
|Transfused during transplant hospitalization||30.3%||15.7%||0.03|
|Hematoma requiring drainage by 90 days||4.6%||8.4%||0.35|
|Patient survived 1 year||93.9%||98.8%||0.10|
|Graft functioning at 1 year||86.4%||97.6%||0.009|
|Had transplant biopsy by 1 year||38.1%||41.5%||0.68|
|Admission for cardiovascular reasons||9.1%||7.2%||0.68|
Conclusions: Among kidney transplant recipients with cardiovascular disease, use of DAPT therapy at the time of transplant is common and associated with need for peri-transplant transfusion and lower 1-year allograft survival. Kidney transplantation among these patients, however, appears to be generally safe.
CITATION INFORMATION: Weng F, Athavale A, Hussain K, Tibaldi K, Rogal G. Complications of Dual Antiplatelet Therapy Among Recipients of Kidney Transplants. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Weng F, Athavale A, Hussain K, Tibaldi K, Rogal G. Complications of Dual Antiplatelet Therapy Among Recipients of Kidney Transplants. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/complications-of-dual-antiplatelet-therapy-among-recipients-of-kidney-transplants/. Accessed July 8, 2020.
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