Do inherited hypercoagulable states play a role in thrombotic events affecting kidney/pancreas transplant recipients?
BACKGROUND
Pancreas graft thrombosis remains the leading non-immunologic cause of graft loss after pancreas transplantation. We studied the role of hypercoagulable states (HCS) in pancreas graft thrombosis (pthx).


METHODS
Between January 1, 1994, and January 1, 2003, 131 pancreas transplant recipients experienced a pthx (n = 67) or other thrombotic events. Fifty-six recipients consented to have their blood drawn and tested for the HCS. These results were compared with a control group of pancreas transplant recipients who did not experience a thrombotic event. Fisher's exact test was used to compare the groups.


RESULTS
We found 18% of the recipients with pancreas thrombosis to have a HCS. Factor V Leiden (FVL) was found in 15% vs. 4% in the control group (p = ns) vs. 3-5% in the general white population. We found 3% of the pancreas thrombosis patients to have a prothrombin gene mutation (PGM) vs. 0% in the control group (p = ns) vs. 1-2% in the general white population.


CONCLUSIONS
Of pancreas transplant recipients with thrombosis, 18% had one or more of the most common factors associated with a HCS (FVL or PGM). This can be compared with 4% in a control group and 4-7% in the general white population, respectively. Although the differences are not statistically significant due to small numbers, we feel that the findings may be clinically relevant. While this is only a pilot study, it may be reasonable to screen select pancreas transplant candidates for HCS, especially FVL and PGM, until more data become available.
Adrogué
Horacio E
HE
Department of Medicine, O'Brien Kidney Research Center, Baylor College of Medicine, Methodist Hospital, Houston, TX, USA. horacioa@bcm.edu
Matas
Arthur J
AJ
McGlennon
R C
RC
Key
Nigel S
NS
Gruessner
Angelika
A
Gruessner
Rainer W
RW
Humar
Abhinav
A
Sutherland
David E R
DE
Kandaswamy
Raja
R
D000328:Adult; D005165:Factor V / Q000032:analysis; D006720:Homozygote; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics; D009154:Mutation; D016035:Pancreas Transplantation / Q000009:adverse effects*; D011183:Postoperative Complications / Q000453:epidemiology; D012016:Reference Values; D012189:Retrospective Studies; D019851:Thrombophilia / Q000235:genetics*; D013927:Thrombosis / Q000453:epidemiology*
C095381:factor V Leiden; D005165:Factor V; D042965:Methylenetetrahydrofolate Reductase (NADPH2)