Simultaneous pancreas-kidney transplantation in patients with antiphospholipid syndrome.
BACKGROUND
Graft thrombosis is one of the main reasons of graft loss following simultaneous pancreas-kidney transplantation (SPK). Although antiphospholipid syndrome (APLS) is known as a high risk for graft thrombosis in kidney transplants alone, little is known about APLS in SPK.


METHODS
Between September 2000 and December 2001, 45 SPK were performed. The treatment and clinical course of 2 patients with APLS is presented.


RESULTS
In one patient, APLS was known before transplantation. After SPK, she was treated by systemic heparin followed by coumarin. Both grafts are doing well 5 months posttransplant. The second patient underwent SPK without knowledge of APLS. The patient developed a deep vein thrombosis 5 weeks posttransplant. Hypercoagulability screening revealed APLS. Treatment consisted of systemic anticoagulation. Grafts were not affected.


CONCLUSIONS
SPK can successfully be performed in APLS patients if anticoagulation is performed consistently. To reduce the risk of graft thrombosis, a pretransplant screening for APLS would probably be of benefit.
Wullstein
C
C
Department of Surgery, Knappschaftskrankenhaus Ruhr-University Bochum, Bochum, Germany. christoph.wullstein@kgu.de
Woeste
G
G
Zapletal
C
C
Dette
K
K
Bechstein
W O
WO
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000188:drug therapy / Q000601:surgery*; D005260:Female; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation; D008875:Middle Aged; D016035:Pancreas Transplantation; D020246:Venous Thrombosis / Q000188:drug therapy
D000925:Anticoagulants