PMID- 20005367
OWN - NLM
STAT- MEDLINE
DCOM- 20100423
LR  - 20131121
IS  - 1873-2623 (Electronic)
IS  - 0041-1345 (Linking)
VI  - 41
IP  - 10
DP  - 2009 Dec
TI  - Preventing graft thrombosis after renal transplantation: a multicenter survey of 
      clinical practice.
PG  - 4193-6
LID - 10.1016/j.transproceed.2009.07.106 [doi]
AB  - BACKGROUND: Renal allograft vascular thrombosis is a complication that often 
      results in graft loss. Since there are no guidelines on immediate postoperative 
      thromboprophylaxis, we performed a telephone survey of clinical practice in all 
      renal transplantation centers in France. METHODS: Each center considered 4 cases 
      relating to renal transplant candidates on dialysis with an increasing risk of 
      thrombosis: Case 1: patient with no identified risk factors; Case 2: patient with 
      an earlier incidence of deep vein thrombosis; Case 3: patient with ischemic heart 
      disease on antiplatelet therapy; Case 4: patient with atrial fibrillation taking 
      a vitamin K antagonist (VKA) with lupus nephritis syndrome. RESULTS: The 
      treatments proposed by the centers (%) were: Case 1: No anticoagulation therapy 
      (57.1%), calcium heparin at prophylactic doses (P-dose) (40%), or unfractionated 
      heparin (UFH); (P-dose; 2.9%). Case 2: No anticoagulation therapy (34.3%), 
      calcium heparin (P-dose; 51.4%), or UFH (P-dose; 5.7%). Case 3: (A) Interruption 
      of aspirin (65.7%), and either no anticoagulation therapy (21.7%) or substitution 
      of aspirin by calcium heparin (P-dose; 56.6%) or by UFH (P-dose; 8.7%). (B) No 
      interruption of aspirin (34.3%), and either no additional prophylaxis (58.3%) or 
      calcium heparin (P-dose; 33.3%). Case 4: Interruption of VKA (100%), and UFH at a 
      curative dose (68.6%), UFH (P-dose; 14.3%), or calcium heparin (P-dose; 11.4%). 
      CONCLUSIONS: Practices varied widely in the absence of studies of sufficiently 
      high power. There is a need for a preoperative classification of thrombotic and 
      hemorrhagic risk among renal transplant candidates and for consensus guidelines.
FAU - Ripert, T
AU  - Ripert T
AD  - Department of Urology, CHU Robert Debre, REIMS, Champagne Ardennes, France. 
      thomas_ripert@yahoo.fr
FAU - Menard, J
AU  - Menard J
FAU - Schoepen, Y
AU  - Schoepen Y
FAU - Nguyen, P
AU  - Nguyen P
FAU - Rieu, P
AU  - Rieu P
FAU - Staerman, F
AU  - Staerman F
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - United States
TA  - Transplant Proc
JT  - Transplantation proceedings
JID - 0243532
RN  - 0 (Anticoagulants)
RN  - 37270-89-6 (calcium heparin)
RN  - 9005-49-6 (Heparin)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anticoagulants/therapeutic use
MH  - Aspirin/therapeutic use
MH  - Female
MH  - France
MH  - Health Surveys
MH  - Heparin/therapeutic use
MH  - Humans
MH  - Intermittent Pneumatic Compression Devices
MH  - Kidney Transplantation/*adverse effects
MH  - Male
MH  - Middle Aged
MH  - Physicians
MH  - Telephone
MH  - Treatment Failure
MH  - Venous Thrombosis/*epidemiology/etiology/prevention & control
EDAT- 2009/12/17 06:00
MHDA- 2010/04/24 06:00
CRDT- 2009/12/17 06:00
PHST- 2009/05/14 00:00 [received]
PHST- 2009/07/28 00:00 [accepted]
PHST- 2009/12/17 06:00 [entrez]
PHST- 2009/12/17 06:00 [pubmed]
PHST- 2010/04/24 06:00 [medline]
AID - S0041-1345(09)01317-7 [pii]
AID - 10.1016/j.transproceed.2009.07.106 [doi]
PST - ppublish
SO  - Transplant Proc. 2009 Dec;41(10):4193-6. doi: 10.1016/j.transproceed.2009.07.106.