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Direct Oral Anticoagulation Use in Kidney Transplant Recipients

S. Shaikh,1 M. Samaniego,2 J. Park.2

1MedStar Georgetown University Hospital, Washington DC
2Michigan Medicine, Ann Arbor, MI.

Meeting: 2018 American Transplant Congress

Abstract number: A216

Keywords: Anticoagulation, Kidney transplantation

Session Information

Date: Saturday, June 2, 2018

Session Name: Poster Session A: Kidney: Cardiovascular and Metabolic

Session Time: 5:30pm-7:30pm

 Presentation Time: 5:30pm-7:30pm

Location: Hall 4EF

Related Abstracts
  • Anticoagulation in Pediatric Liver Transplantation; the Pros and Cons
  • Risk of Major Bleeding in Solid Organ Transplant Recipients Taking Calcineurin Inhibitors Concomitantly with Direct Oral Anticoagulants Compared to Warfarin.

Objective: There is a lack of high-level evidence identifying meaningful outcomes with direct oral anticoagulants (DOACs) in kidney transplant recipients. The primary objective of this study was to evaluate outcomes resulting from DOAC use in kidney transplant recipients.

Methods: In this single-center retrospective chart review, we evaluated adult kidney transplant recipients receiving DOAC therapy for cerebrovascular accident prophylaxis in non-valvular atrial fibrillation, or venous thromboembolism prophylaxis or treatment from January 1, 2011 to August 31, 2016. The primary outcome assessed the incidence of major bleeding events defined as a decrease in hemoglobin (Hgb) by at least 2 g/dl, transfusion of at least 2 units of blood, or symptomatic bleeding in a critical area or organ during DOAC therapy.

Results: According to our predefined inclusion criteria, 62 patients were included in the study. Fourteen patients (22.6%) experienced a major bleed during DOAC therapy for a median follow-up of 8.7 months, leading to therapy discontinuation in 7 patients. There was no statistical difference in the incidence of major bleeding events between patients identified as receiving the appropriate DOAC dose versus those who did not receive appropriate dosing (19.4% vs. 3.2%, p = 1.00). Similarly, there was no difference in the incidence of major bleeding between patients with identified drug-drug interactions and those without drug-drug interactions (3.2% vs. 11.3%, p = 1.00).

Table 1. Safety and Efficacy Outcomes Overall (N=62)
Major bleeding event

Reduciton in Hgb of at least 2 g/dl

Transfusion of at least 2 units of blood

Symptomatic bleeding in critical area/organ

14 (22.6%%)

10 (71.4%)

3 (4.8%)

1 (1.6%)

DOAC associated with major bleeding event

Apixaban

Dabigatran

Edoxaban

Rivaroxaban

7 (50%)

6 (42.9%)

0

1 (7.1%)

Minor bleeding event 9 (14.5%)
Cerebrovascular accident 0
Breakthrough VTE 0
Discontinued DOAC therapy 7 (11.3%)
Hgb: hemoglobin; VTE: venous thromboembolism; DOAC: direct oral anticoagulant

All data are presented in n (%).

Conclusions: DOAC therapy was not well tolerated in this cohort of kidney transplant recipients with respect to safety.

CITATION INFORMATION: Shaikh S., Samaniego M., Park J. Direct Oral Anticoagulation Use in Kidney Transplant Recipients Am J Transplant. 2017;17 (suppl 3).

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To cite this abstract in AMA style:

Shaikh S, Samaniego M, Park J. Direct Oral Anticoagulation Use in Kidney Transplant Recipients [abstract]. https://atcmeetingabstracts.com/abstract/direct-oral-anticoagulation-use-in-kidney-transplant-recipients/. Accessed January 15, 2021.

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