title: The risk of thromboembolic events in kidney transplant patients.
abstract: Little is known about the risk of venous thrombosis following kidney transplant. To determine this we estimated the risk of thromboembolic events (TEs) in a cohort of consecutive patients who underwent kidney transplantation at a single tertiary care center over an 11-year period and calculated standardized incidence ratios (SIRs) for a first TE in kidney transplant recipients compared with the general population. We then performed a nested case-control study and compared patients with and without TEs to identify risk factors for thrombosis. Among 913 kidney transplant recipients (KTRs), 68 patients developed these events. The SIR for TEs in KTRs compared with the general population was 7.9 over the duration of follow-up. The risk was particularly higher in the first post-transplant year (SIR 26.1) but remained elevated afterward (SIR 5.2). Hospitalization, use of sirolimus, low hemoglobin level, and use of renin-angiotensin system inhibitors were independently associated with these events. When cases of TEs that occurred during hospitalization were excluded, the risk of these events remained elevated. The risk of TEs in KTRs was eightfold higher than in the general population but not fully explained by the increased risk associated with hospitalization. Our results underscore the important risk of thrombosis in patients who received a kidney transplant, making vigilance mandatory especially during hospitalization.
authors.affiliation: 1] Research Centre, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada [2] Research Centre, Centre Hospitalier de l'Université de Montréal, Hôpital Notre Dame, Université de Montréal, Montréal, Québec, Canada.
authors.forename: Jacobien C
authors.initials: JC
authors.lastname: Verhave
authors.affiliation: Center for Clinical Epidemiology, Lady Davis Institute Research Centre, Jewish General Hospital, McGill University, Montréal, Québec, Canada.
authors.forename: Vicky
authors.initials: V
authors.lastname: Tagalakis
authors.affiliation: Center for Clinical Epidemiology, Lady Davis Institute Research Centre, Jewish General Hospital, McGill University, Montréal, Québec, Canada.
authors.forename: Samy
authors.initials: S
authors.lastname: Suissa
authors.affiliation: Research Centre, Centre Hospitalier de l'Université de Montréal, Hôpital Notre Dame, Université de Montréal, Montréal, Québec, Canada.
authors.forename: François
authors.initials: F
authors.lastname: Madore
authors.affiliation: Research Centre, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada.
authors.forename: Marie-Josée
authors.initials: MJ
authors.lastname: Hébert
authors.affiliation: Research Centre, Centre Hospitalier de l'Université de Montréal, Hôpital Notre Dame, Université de Montréal, Montréal, Québec, Canada.
authors.forename: Héloïse
authors.initials: H
authors.lastname: Cardinal
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D011792:Quebec; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D020123:Sirolimus / Q000009:adverse effects; D062606:Tertiary Care Centers; D013923:Thromboembolism / Q000209:etiology*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus