The impact of peritransplant warfarin use on renal transplant outcome.
BACKGROUND
The unplanned nature of kidney transplantation necessitates that patients undergo surgery without prior cessation of warfarin. Our study analyses the impact of warfarin treatment in the peritransplant period on graft outcome and perioperative transfusion requirements.


METHODS
We identified 31 patients undergoing deceased donor kidney transplantation who were concurrently receiving warfarin therapy, between 2000 and 2008. A random, sex-matched, adult, deceased donor control group of 62 patients was generated from the Irish transplant database.


RESULTS
The warfarin group were older (mean 47.5 vs. 42.5 years, p=0.067) and had spent longer on dialysis prior to transplantation (mean 3.5 vs. 2.1 years, p=0.004). Graft survival in the warfarin group was not significantly different at 1-, 3- and 5-year follow-ups. There was no statistically significant difference in red blood cell transfusions between the groups (45% vs. 29%, p=0.2). Warfarin patients had a prolonged mean cold ischaemia time (22.3 vs. 18.5 hours, p=0.002).


CONCLUSIONS
This study demonstrates excellent short- and long-term results for kidney transplantation in patients requiring warfarin at the time of transplantation.
Department of Nephrology, Beaumont Hospital, Dublin, Ireland.
Dervla M
DM
Connaughton
Paul J
PJ
Phelan
Jansen
J
Scheult
Marwan
M
Ma'ayeh
Patrick
P
O'Kelly
Joseph J
JJ
Walshe
Colm
C
Magee
Dilly
D
Little
David
D
Hickey
Jiri
J
Slaby
Peter J
PJ
Conlon
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014859:Warfarin / Q000627:therapeutic use*
D000925:Anticoagulants; D006454:Hemoglobins; D014859:Warfarin