Renal transplant recipients are at high risk for both symptomatic and asymptomatic deep vein thrombosis.
BACKGROUND
Venous thromboembolism (VTE) is one of the thrombotic complications that can occur in patients receiving renal transplantation (RT). The prevalence of VTE in RT patients is, however, undefined.


OBJECTIVE
To evaluate the rate of a first episode of VTE in a series of 538 consecutive RT recipients admitted to our institution, the timing of occurrence of the thromboembolic events after transplantation, and the rate of recurrence after thromboprophylaxis withdrawal. Risk factors for recurrence were also evaluated, particularly in relation to the type of the first event (symptomatic or asymptomatic).


RESULTS
During follow-up, 47 of 518 patients (28 males, 19 females; 9.1%) developed a first episode of VTE at a median time of 17 months (range 1-165 months) after kidney transplantation. Cancer was associated with the occurrence of VTE (odds ratio 4.8). Seventeen of 43 patients (39.5%) with deep vein thrombosis were asymptomatic and the diagnosis was made during routine ultrasound examination. Twenty-two patients (46.8%) experienced a recurrence of VTE. A relevant rate of recurrence was documented amongst patients with a first episode of both symptomatic (53%) and asymptomatic (23.5%) VTE.


CONCLUSIONS
This study confirms that RT patients are at high risk of symptomatic and asymptomatic VTE and that this risk persists even after several years. Patients who experience VTE are at high risk of recurrence after thromboprophylaxis withdrawal.
Poli
D
D
Department of Critical Care Medicine, Thrombosis Centre, Azienda Ospedaliera Universitaria Careggi, Viale Morgagni 85, 50134 Florence, Italy. polida@ao-careggi.toscana.it
Zanazzi
M
M
Antonucci
E
E
Bertoni
E
E
Salvadori
M
M
Abbate
R
R
Prisco
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D019934:International Normalized Ratio; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020246:Venous Thrombosis / Q000209:etiology* / Q000517:prevention & control
D000925:Anticoagulants