Hemorrhagic complications of enoxaparin and aspirin in patients with kidney transplants.
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.
Shullo
Michael A
MA
Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pennsylvania 15213, USA.
Rose
Meredith L
ML
Vivas
Carlos
C
Jordan
Mark L
ML
Scantlebury
Velma P
VP
Jain
Ashok
A
Corry
Robert J
RJ
Fung
John J
JJ
McCauley
Jerry
J
Johnston
James
J
Shapiro
Ron
R
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
D000925:Anticoagulants; D017984:Enoxaparin; D005343:Fibrinolytic Agents; D006454:Hemoglobins; D001241:Aspirin