Thrombosis after kidney transplantation.
The diagnosis of deep vein thrombosis (DVT) is unusual in patients with sickle cell disease (SCD). Despite the incidence of cerebral thrombosis in SCD patients due to vasooclusion, thrombotic manifestations in peripheral vessels are rare. Patients with homozygous SCD present a variety of renal abnormalities as a result of sickle crisis. In this group of patients, kidney transplantation has been performed in the renal endstage patients; with graft survival rates similar to that of the general transplant population at 1 year. However, patients with SCD experience an augmentation in the frequency of painful crises in the first year after transplantation, which has been attributed to concurrent elevations in hematocrit and plasma viscosity. Despite etiology, renal transplant patients are at increased risk for the development of thromboembolic events such as deep vein thrombosis and renovascular thrombosis after allograft procedure. These events can be due to a prothrombotic state generated by the use of immunosuppressive agents. Although other factors such as acquired or inherited disorders of the clotting system may increase the risk of thrombosis. Here, we report a case of a renal transplant patient with sickle cell disease who presented recurrent episodes of DVT and increase painful sickle episodes after kidney transplantation.
Fischer
Gustavo Brandão
GB
Complexo Hospitalar Santa Casa de Porto Alegre, Brazil. arachinini@hotmail.com
da Rosa
Ana Cecília Michel
AC
D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications*; D000925:Anticoagulants / Q000627:therapeutic use; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D019698:Hepatitis C, Chronic / Q000150:complications; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D010951:Plasma Exchange; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology* / Q000517:prevention & control / Q000628:therapy; D012008:Recurrence; D019851:Thrombophilia / Q000188:drug therapy / Q000209:etiology; D013924:Thrombophlebitis / Q000188:drug therapy / Q000209:etiology* / Q000517:prevention & control / Q000628:therapy
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D007166:Immunosuppressive Agents