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Risk Factors in Venous Thrombosis of Renal Grafts from Deceased Non Heart-Beating Donors

M. Molina, E. Gonzalez, N. Polanco, L. Garcia-Puente, A. Sevillano, E. Gutierrez, E. Morales, A. Hernandez, J. Morales, A. Andres

Nephrology, Hospital 12 Octubre, Madrid, Spain

Meeting: 2013 American Transplant Congress

Abstract number: 314

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Background: The deceased donor kidney transplant to non heart-beating may have a higher rate of venous thrombosis (VT).The aim of this study is to analyze whether resistance index (RI) high (≥ 0.8), measured by Doppler ultrasound can be a predictor of VT. We also analyzed whether early anticoagulation may decrease graft loss associated with VT.

Methods: We analyzed 227 patients with renal transplant non heart-beating donor made since 2005-2012. In November 2009 began prophylactic anticoagulation if RI were elevated. Patients were divided in group I(no anticoagulation historical group) and group II(anticoagulated by RI).

Results: The Table 1 compares the Group I to Group II. In univariate analysis cold ischemia time, body mass index of the donor, antitimocitic globuline and high RI were factors that were associated with VT of the graft. In multivariate analysis thymoglobulin treatment was a risk factor associate with VT (p 0,03, HR 5,2 IC 1,1-23,8).

Comparation between Group I and Group II
  Group I (n =88) Group II (n = 139) P
RECIPIENT      
Age (years) 45,6±11 49,4±11,6 p<0,05
Men 55,7% 64% Ns
First transplant 94,3% 94,2% Ns
Hyperimmunized 1,1% 0,7% Ns
Mismatches 4,2±1,2 4,6±1 p<0,01
Cold ischemia time (minutes) 879±308,8 701±265,5 p<0,01
Antitimocitic globuline 83% 96,4% p<0,01
DONOR      
Age (years) 38,3±9,7 46,9±10 p<0,01
Men 90,9% 84,9% Ns
Weight (kg) 85,1±13,7 78±11 p<0,01
Creatinine (mg/dl) 1,1±0,3 1,2±0,4 Ns
EVOLUTION      
Inmediate renal function 14,8% 15,1% Ns
Acute tubular necrosis (days) 13,6±5,8 13,5±7,3 Ns
Resistance indices in the doppler 0,7±0,1 0,7±0,1 Ns
High resistance rates 35,2% 41,7% Ns
Loss of graft 11,4% 5% Ns
Anticoagulation 0% 26,6% p<0,01
Venous thrombosis 8% 0% p<0,01
Acute rejection 12,5% 10,8% Ns
Receptor survival 98,9% 100% Ns
Hematuria/Surgery/Transfusion 6,8%/8%/13,6% 10,8%/2,9%/28,8% Ns/Ns/p<0,01

We analyzed the subgroup of 89 patients with high RI, 34 patients were anticoagulated, and none had a VT compared with 55 patients who received no anticoagulation, of which 7 had vascular thrombosis (0% vs 14,5% p<0,05).

Conclusions: This study suggests that in renal transplant from non heart beeting donor when RI is higher than 0,8, anticoagulation may decrease the rate of VT. In these transplants, a careful choice of donor and reduced cold ischemia time are related with better result.

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To cite this abstract in AMA style:

Molina M, Gonzalez E, Polanco N, Garcia-Puente L, Sevillano A, Gutierrez E, Morales E, Hernandez A, Morales J, Andres A. Risk Factors in Venous Thrombosis of Renal Grafts from Deceased Non Heart-Beating Donors [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/risk-factors-in-venous-thrombosis-of-renal-grafts-from-deceased-non-heart-beating-donors/. Accessed April 22, 2021.

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