Do inherited hypercoagulable states play a role in thrombotic events affecting kidney/pancreas transplant recipients?

Horacio E. Adrogué, Arthur J Matas, R. C. McGlennon, Nigel S. Key, Angelika Gruessner, Rainer W. Gruessner, Abhinav Humar, David E.R. Sutherland, Raja Kandaswamy

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

Background: Pancreas graft thrombosis remains the leading non-immunologic cause of graft loss after pancreas transplantation. We studied the role of hypercoagulable states (HCS) in pancreas graft thrombosis (pthx). Methods: Between January 1, 1994, and January 1, 2003, 131 pancreas transplant recipients experienced a pthx (n = 67) or other thrombotic events. Fifty-six recipients consented to have their blood drawn and tested for the HCS. These results were compared with a control group of pancreas transplant recipients who did not experience a thrombotic event. Fisher's exact test was used to compare the groups. Results: We found 18% of the recipients with pancreas thrombosis to have a HCS. Factor V Leiden (FVL) was found in 15% vs. 4% in the control group (p = ns) vs. 3-5% in the general white population. We found 3% of the pancreas thrombosis patients to have a prothrombin gene mutation (PGM) vs. 0% in the control group (p = ns) vs. 1-2% in the general white population. Conclusions: Of pancreas transplant recipients with thrombosis, 18% had one or more of the most common factors associated with a HCS (FVL or PGM). This can be compared with 4% in a control group and 4-7% in the general white population, respectively. Although the differences are not statistically significant due to small numbers, we feel that the findings may be clinically relevant. While this is only a pilot study, it may be reasonable to screen select pancreas transplant candidates for HCS, especially FVL and PGM, until more data become available.

Original languageEnglish (US)
Pages (from-to)32-37
Number of pages6
JournalClinical Transplantation
Volume21
Issue number1
DOIs
StatePublished - Jan 2007

Keywords

  • FVL
  • HCS
  • PGM
  • Pancreas graft fibrasis
  • Pancreas transplant
  • Thrombosis

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