Risk Factors in Venous Thrombosis of Renal Grafts from Deceased Non Heart-Beating Donors
Nephrology, Hospital 12 Octubre, Madrid, Spain
Meeting: 2013 American Transplant Congress
Abstract number: 314
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).
| 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.
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 October 26, 2020.« Back to 2013 American Transplant Congress