title: Necessity of routine postoperative heparinization in non-risky live-donor renal transplantation: results of a prospective randomized trial.
abstract: OBJECTIVE
  To determine the exact value of postoperative heparinization in preventing thrombotic sequelae in non-risky renal transplants and to assess the possible hazards of this therapy through a prospective randomized trial.
  
  
  METHODS
  Of 120 consecutive live-donor renal transplants, 45 patients were excluded because of young age, multiple or atheromatous graft arteries, a history of thromboembolic disease, or intraoperative technical difficulties. The remaining patients were prospectively randomized into three groups, with 25 patients each. Group 1 did not undergo heparinization. Groups 2 and 3 received a prophylactic dose of low-molecular-weight heparin and conventional heparin, respectively, for 1 week.
  
  
  RESULTS
  None of our patients in any group developed graft vascular thrombosis, deep venous thrombosis, or pulmonary embolism, and the rate of spontaneous closure of arteriovenous fistulas was comparable among the three groups (P = 0.79). No statistically significant difference was found among the three groups in terms of the development of significant perirenal hematomas, rate of blood transfusions, or mean number of transfused units (P = 0.37, P = 0.56, and P = 0.69, respectively). In contrast, a significant decrease in the hemoglobin level occurred in group 3 compared with group 1 among nontransfused patients (1.6 +/- 0.8 g% and 0.7 +/- 0.9 g%, respectively; P = 0.01). Moreover, a significant shortening of lymph drainage time and a reduction of the total amount of lymphorrhea were found in group 1 compared with groups 2 and 3 (P = 0.01, P = 0.03, respectively).
  
  
  CONCLUSIONS
  Postoperative heparinization should not be routinely indicated in non-risky live-donor renal transplantation.
authors: Urology and Nephrology Center, Mansoura University, Mansoura, Egypt. y_osman99@yahoo.com
authors: Yasser
authors: Y
authors: Osman
authors: Mohamed
authors: M
authors: Kamal
authors: Shady
authors: S
authors: Soliman
authors: Hussein
authors: H
authors: Sheashaa
authors: Ahmed
authors: A
authors: Shokeir
authors: Ahmed B
authors: AB
authors: Shehab el-Dein
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D011182:Postoperative Care; D011446:Prospective Studies; D013927:Thrombosis / Q000209:etiology* / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight