Venous thromboembolic complications after kidney and kidney-pancreas transplantation: A multivariate analysis

A. Humar, E. M. Johnson, K. J. Gillingham, D. E. Sutherland, W. D. Payne, D. L. Dunn, L. E. Wrenshall, J. S. Najarian, R. W. Gruessner, A. J. Matas

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92 Scopus citations


Background: We reviewed the incidence of and risk factors for venous thromboembolic complications in our population of kidney (KTx) and simultaneous kidney-pancreas transplant (SPK) recipients. methods: Information was collected retrospectively from a database on 1833 KTx and 276 SPK recipients who underwent transplant surgery between January 1985 and August 1995. Results. The incidence of deep venous thrombosis (DVT) was 6.2%(n = 132), with significantly higher rates after SPK (18.1%) vs. KTx (4.5%) (P<0.001). The number of DVT episodes was highest in the first month; 17.5% occurred during this tine. For KTx recipients, early thrombotic events were more common on the side of the graft (P=0.03); however, after 1 month, no correlation existed between the side of the graft and the side of DVT. For SPK recipients, DVT tended to be more common on the side of the pancreas (57%) vs. the kidney (43%) (P=0.10). By multivariate analysis, risk factors for DVT were: age >40 years (odds ratio [OR]=2.2, P<0.001), diabetes mellitus (DM) (OR=2.0, P=0.002) previous DVT (OR=4.4, P=0.001) and SPK transplant (OR=2.8, P<0.001). Pulmonary embolus (PE) was identified in 44 recipients (incidence, 2.1%) and was fatal in 13 (30%). The incidence was significantly higher in SPK (4.71%) vs. KTx recipients (1.69%) (P<0.01). The risk of death from PE was 0.5% in KTx recipients and 1.37% in SPK recipients (P=0.08). Risk factors for PE included DM (OR=2.6, P=0.005) and recent DVT (OR=8.9, P=0.0001). Conclusions. Based on risk and extrapolating from the general surgical literature, our recommendations for prophylaxis against DVT are use of graduated compression stockings for all recipients and, in addition, low- dose heparin for moderate and high-risk recipients (previous DVT, SPK, age>40 years, DM).

Original languageEnglish (US)
Pages (from-to)229-234
Number of pages6
Issue number2
StatePublished - Jan 27 1998


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