Federico Cicora1, Jorgelina Petroni1, Javier Roberti2. 1. Foundation for Research and Assistance in Kidney Disease-FINAER, Austria 2381, 5D, 1425, Buenos Aires, Argentina. 2. Foundation for Research and Assistance in Kidney Disease-FINAER, Austria 2381, 5D, 1425, Buenos Aires, Argentina. javierroberti@gmail.com.
Abstract
PURPOSE OF REVIEW: Kidney transplant recipients have an increased risk of pulmonary embolism; however, thromboprophylaxis poses a challenge as the risk of thrombosis must be balanced against the risk of bleeding. This review summarizes the evidence on whether thromboprophylaxis is required in kidney transplantation. RECENT FINDINGS: Incidence of venous thromboembolism, comprising pulmonary embolism and deep venous thrombosis, is increased in kidney transplant recipients compared to the general population, with augmented risk of death and graft loss. Findings suggest a benefit of prophylaxis with heparin and mechanical prophylaxis for low-risk patients. For patients at high risk, with previous thrombosis, and/or abnormal thrombophilia screen, dose and prophylaxis time need to be increased. There is no established thromboprophylaxis strategy. It is crucial to evaluate patient's risk profile and opt for a multidisciplinary approach for the development of appropriate prophylaxis. There remains a paucity of high-quality evidence for effective prophylaxis strategies in this population.
PURPOSE OF REVIEW: Kidney transplant recipients have an increased risk of pulmonary embolism; however, thromboprophylaxis poses a challenge as the risk of thrombosis must be balanced against the risk of bleeding. This review summarizes the evidence on whether thromboprophylaxis is required in kidney transplantation. RECENT FINDINGS: Incidence of venous thromboembolism, comprising pulmonary embolism and deep venous thrombosis, is increased in kidney transplant recipients compared to the general population, with augmented risk of death and graft loss. Findings suggest a benefit of prophylaxis with heparin and mechanical prophylaxis for low-risk patients. For patients at high risk, with previous thrombosis, and/or abnormal thrombophilia screen, dose and prophylaxis time need to be increased. There is no established thromboprophylaxis strategy. It is crucial to evaluate patient's risk profile and opt for a multidisciplinary approach for the development of appropriate prophylaxis. There remains a paucity of high-quality evidence for effective prophylaxis strategies in this population.
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Authors: A Gigante; F Di Mario; A Pierucci; A Amoroso; F S Pignataro; L Napoleone; S Basili; V Raparelli Journal: Eur J Intern Med Date: 2017-03-01 Impact factor: 4.487
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Authors: Gertrude J Nieuwenhuijs-Moeke; Tamar A J van den Berg; Stephan J L Bakker; Marius C van den Heuvel; Michel M R F Struys; Ton Lisman; Robert A Pol Journal: PLoS One Date: 2018-07-16 Impact factor: 3.240