Do we need screening for thrombophilia prior to kidney transplantation?

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
Joachim AndrassyKonrad Andrassy

Abstract

There is increased risk for the occurrence of deep venous thrombosis (DVT) and renovascular thrombosis after kidney transplantation. A disruption of the blood homeostasis caused by surgery and leading to clotting and bleeding malfunctions is widely accepted. However, other causes such as inherited or acquired disorders of the clotting system may further increase the risk of thrombosis. Here, we summarize and review data on possible causes, incidence and ways to prevent the occurrence of DVT and/or renovascular thrombosis after kidney transplantation. The incidence of DVT after kidney transplantation is 6.2-8.3% and approximately 25% of these patients suffer from pulmonary embolism. The DVT occurs primarily on the side of the transplant with an increased risk throughout the first 5 months after transplantation. Thereby, 2-12% of the patients develop renovascular thromboses, most of which are related directly to the surgery. However, inherited or acquired thrombophilia may also play an important role. A severe course is known for prothrombin gene G20210A polymorphism, which can result in graft loss. A great diversity of prophylactic treatments is available but adjustment to the underlying circumstances is crucial for a favourable...Continue Reading

Citations

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