title: [Incidence of thrombophilia and risk of renal vessel thrombosis in kidney transplant recipients].
abstract: BACKGROUND
  Kidney transplantation is the optimal treatment of end stage kidney disease. The most common vascular complication in the early postoperative period is thrombosis of the renal artery and vein. These complications usually lead to the loss of the transplanted kidney.
  
  
  OBJECTIVE
  of our study was to identify those factors which represent an increased risk for thrombotic complication and determine whether routine screening for thrombophilia is justifiable before transplantation. As an illustration to this problem we report a case of successful renal vein recanalisation after thrombosis.
  
  
  METHODS
  We give an overview of the literature about incidence of renal graft thrombosis, hypercoagulable states, predictive value of factor V. Leiden and prothrombin G20210A mutations in venous thromboembolism. We discuss those publications that suggest a preoperative screening of transplant candidates for hypercoagulable states and thrombophilia and those that do not think that such screening is reasonable. In our case a 28 year old male patient received a cadaveric kidney. Thrombosis of the renal vein was diagnosed 8 hours after transplantation. Reoperation was performed immediately: venous anastomosis was opened, the thrombus removed. After reoperation the circulation of the kidney recovered, intravenous heparin treatment was introduced immediately.
  
  
  RESULTS
  24 months later the kidney is still functioning well. Postoperative thrombophilia screening showed heterozygosity for factor V Leiden.
  
  
  CONCLUSIONS
  There are only few publications reporting on successful recanalisation after renal vein thrombosis. In our case rapid diagnosis and immediate operative treatment saved the graft. There is no uniform proposal in the literature whether preoperative screening for thrombophilia is justifiable or not. In our view screening for thrombophilia and thromboprophylaxis is mandatory. Extensive prospective studies should be undertaken to refine the risks and establish the associations of thrombophilia and thromboembolism after kidney transplantation.
authors: Semmelweis Egyetem Transzplantációs és Sebészeti Klinika 1082 Budapest Baross u. 23-25. eteoronyi@gmail.com
authors: Eva
authors: E
authors: Toronyi
authors: Zsolt
authors: Z
authors: Máthé
authors: Rita
authors: R
authors: Chmel
authors: Marina
authors: M
authors: Varga
authors: Veronika
authors: V
authors: Kozma
authors: Roland
authors: R
authors: Trent
authors: Gellért
authors: G
authors: Tozsér
authors: Gergely
authors: G
authors: Nagy
authors: Róbert
authors: R
authors: Langer
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage; D005165:Factor V / Q000235:genetics*; D006084:Graft Rejection / Q000453:epidemiology / Q000235:genetics; D006493:Heparin / Q000008:administration & dosage; D006579:Heterozygote; D006801:Humans; D015994:Incidence; D007275:Injections, Intravenous; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D009154:Mutation; D011237:Predictive Value of Tests; D012079:Renal Circulation; D012082:Renal Veins / Q000473:pathology* / Q000601:surgery; D012086:Reoperation; D019851:Thrombophilia / Q000150:complications*; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000175:diagnosis / Q000209:etiology* / Q000235:genetics / Q000517:prevention & control / Q000601:surgery*
chemical_list: D000925:Anticoagulants; C095381:factor V Leiden; D005165:Factor V; D006493:Heparin