title: Hemorrhagic complications of enoxaparin and aspirin in patients with kidney transplants.
abstract: OBJECTIVE
  To evaluate the frequency of early posttransplant hemorrhagic complications in patients with kidney and kidney-pancreas transplants who received thromboprophylaxis with enoxaparin and aspirin.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  University-based tertiary care center.
  
  
  METHODS
  Thirteen patients who had received enoxaparin within 10 days of kidney or kidney-pancreas transplantation.
  
  
  METHODS
  Medical records were reviewed, and data from patients who had received low-dose aspirin 81 mg once/day and enoxaparin within 10 days of transplantation were collected.
  
  
  RESULTS
  Major bleeding events were defined as intracranial or retroperitoneal bleeding, or a decrease in hemoglobin of greater than 2 g/dl that was confirmed on repeat evaluation. Nine (69%) of the 13 patients had confirmed major bleeding events and required blood transfusions. Six of the nine patients had elevated serum creatinine levels.
  
  
  CONCLUSIONS
  The combination of enoxaparin and low-dose aspirin early after kidney or kidney-pancreas transplantation was associated with a high frequency of hemorrhagic events. Further evaluation is needed to determine the safety of enoxaparin in combination with aspirin after transplantation.
authors.affiliation: Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pennsylvania 15213, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Shullo
authors.forename: Meredith L
authors.initials: ML
authors.lastname: Rose
authors.forename: Carlos
authors.initials: C
authors.lastname: Vivas
authors.forename: Mark L
authors.initials: ML
authors.lastname: Jordan
authors.forename: Velma P
authors.initials: VP
authors.lastname: Scantlebury
authors.forename: Ashok
authors.initials: A
authors.lastname: Jain
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Corry
authors.forename: John J
authors.initials: JJ
authors.lastname: Fung
authors.forename: Jerry
authors.initials: J
authors.lastname: McCauley
authors.forename: James
authors.initials: J
authors.lastname: Johnston
authors.forename: Ron
authors.initials: R
authors.lastname: Shapiro
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D001241:Aspirin / Q000009:adverse effects* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D017984:Enoxaparin / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation; D019106:Postoperative Hemorrhage / Q000139:chemically induced*; D012189:Retrospective Studies
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin; D005343:Fibrinolytic Agents; D006454:Hemoglobins; D001241:Aspirin