Preemptively and non-preemptively transplanted patients show a comparable hypercoagulable state prior to kidney transplantation compared to living kidney donors

PloS One
Gertrude J Nieuwenhuijs-MoekeRobert A Pol

Abstract

To prevent renal graft thrombosis in kidney transplantation, centres use different perioperative anticoagulant strategies, based on various risk factors. In our centre, patients transplanted preemptively are considered at increased risk of renal graft thrombosis compared to patients who are dialysis-dependent at time of transplantation. Therefore these patients are given a single dose of 5000 IU unfractionated heparin intraoperatively before clamping of the vessels. We questioned whether there is a difference in haemostatic state between preemptively and non-preemptively transplanted patients and whether the distinction in intraoperative heparin administration used in our center is justified. For this analysis, citrate samples of patients participating in the VAPOR-1 trial were used and several haemostatic and fibrinolytic parameters were measured in 29 preemptively and 28 non-preemptively transplanted patients and compared to 37 living kidney donors. Sample points were: induction anaesthesia (T1), 5 minutes after reperfusion (T2) and 2 hours postoperative (T3). At T1, recipient groups showed comparable elevated levels of platelet factor 4 (PF4, indicating platelet activation), prothrombin fragment F1+2 and D-dimer (indicating ...Continue Reading

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Citations

Jan 19, 2019·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Ton Lisman
Dec 12, 2018·Transplant International : Official Journal of the European Society for Organ Transplantation·Tamar A J van den BergRobert A Pol
Feb 21, 2019·PloS One·Anja GäcklerFuat H Saner

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Methods Mentioned

BETA
biopsies
biopsy
enzyme-linked immunosorbent assays
ELISA

Clinical Trials Mentioned

NCT01248871

Software Mentioned

SPSS
Thrombinoscope
GraphPad Prism
GraphPad

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