title: Incidence of late deep venous thrombosis among renal transplant patients.
abstract: BACKGROUND
  Kidney transplant recipients (KTRs) manifest hypercoagulable state that contributes to an increased incidence of deep vein thrombosis (DVT), not only early but also late in their course. KTRs display an imbalance of hemostatic mechanisms with a multifactorial rise in procoagulant factors, partly related to traditional risk factors and partly to transplantation. The aim of this study was to evaluate the incidence of first episodes of DVT among KTRs, focusing on risk factors.
  
  
  METHODS
  From 2008 to 2011, we evaluated 30 kidney transplant patients who ≥4 months there after transplantation developed DVT in the lower limbs only, lower limbs complicated by pulmonary embolism or retinal thrombosis. We analyzed causes of primary nephropathy, immunosuppressive regimen, post-transplantation infections, and erythrocytosis. DVT was diagnosed by color Doppler ultrasound or eye examination.
  
  
  RESULTS
  A significantly increased incidence of DVT was observed among patients receiving cyclosporine or cyclosporine + mammalian target of rapamycin inhibitors, affected by polycystic kidney diseases, systemic lupus erythematosus or nephrotic syndrome, or displaying rapid and/or excessive correction of hematocrit values. DVT was not significantly related to an acute infection (cytomegalovirus) or to the prior dialysis modality.
  
  
  CONCLUSIONS
  Hypercoagulability is a multifactorial condition in KTRs, representing a severe complication in stable patients. Prevention may consist of either accurate pretransplantation screening for thrombophilia or identification of patients at higher DVT risk.
authors.affiliation: Department of Specialized, Experimental, and Diagnostic Medicine, Section of Nephrology, University of Bologna, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Todeschini
authors.forename: G
authors.initials: G
authors.lastname: La Manna
authors.forename: V
authors.initials: V
authors.lastname: Dalmastri
authors.forename: G
authors.initials: G
authors.lastname: Feliciangeli
authors.forename: V
authors.initials: V
authors.lastname: Cuna
authors.forename: M
authors.initials: M
authors.lastname: Montanari
authors.forename: M L
authors.initials: ML
authors.lastname: Angelini
authors.forename: M P
authors.initials: MP
authors.lastname: Scolari
authors.forename: S
authors.initials: S
authors.lastname: Stefoni
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D020246:Venous Thrombosis / Q000453:epidemiology* / Q000209:etiology