[Renal artery thrombosis after withdrawal from anticoagulation therapy in a kidney transplant recipient with thrombophilia: report of one case].
Kidney graft loss because arterial thrombosis is not common and is related to risk factors such as recurrent vascular hemodialysis access thrombosis, collagen-vascular disease, repeated miscarriage, diabetes mellitus and thrombophilia. Patients having this last disorder have an increased risk of repeated thrombosis in successive transplants unless they receive anticoagulation therapy. We report a 51 year-old diabetic woman who had a history of recurrent vascular hemodialysis access thrombosis (both native and prosthetic) while on dialysis and received a cadaveric donor kidney. One month after transplantation she had axillary vein thrombosis complicated with pulmonary embolism and received anticoagulants for six months. Just days after stopping the anticoagulation, she became suddenly anuric due to renal artery thrombosis and complete graft infarction. The coagulation study showed moderate hyperhomocysteinemia and a significant protein C deficiency (39%). Days after nephrectomy she suffered a femoral vein thrombosis and anticoagulation was prescribed for life.
Vega S
Jorge
J
Servicio de Medicina, Secciones de Nefrología y Hematología, Hospital Naval Almirante Nef, Viña del Mar, Chile. jvega@hospitalnaval.cl
Goecke S
Helmuth
H
Vásquez G
Alejandro
A
Peña M
Armando
A
D000714:Anastomosis, Surgical; D000925:Anticoagulants / Q000627:therapeutic use*; D001367:Axillary Vein; D002408:Catheters, Indwelling; D005260:Female; D005268:Femoral Vein; D006084:Graft Rejection / Q000209:etiology*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications; D016030:Kidney Transplantation; D008875:Middle Aged; D020151:Protein C Deficiency / Q000150:complications; D012008:Recurrence; D012078:Renal Artery Obstruction / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D006435:Renal Dialysis / Q000009:adverse effects; D051437:Renal Insufficiency / Q000628:therapy; D019851:Thrombophilia / Q000150:complications*; D013927:Thrombosis / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D020246:Venous Thrombosis / Q000209:etiology
D000925:Anticoagulants