Evaluation of bleeding rates in renal transplant patients on therapeutic intravenous heparin.
BACKGROUND
It is unknown whether coagulation properties differ between renal transplant and nontransplant patients.


OBJECTIVE
To assess whether renal transplant patients on intravenous (IV) heparin, titrated to therapeutic activated partial thromboplastin times (aPPT; 56-93 seconds), experienced a higher rate of bleeding compared to nontransplant patients.


METHODS
Twenty-nine renal transplant and 29 nontransplant patients receiving IV heparin for a deep vein thrombosis, pulmonary embolism, atrial fibrillation, or acute coronary syndrome were randomly identified through a retrospective chart review.


RESULTS
Renal transplant patients had higher bleeding rates on IV heparin therapy compared to nontransplant patients (31% vs 6.9%, respectively; P = .041). Renal transplant patients experienced a drop in hemoglobin of at least 1 g/dL or the need for a transfusion more often then nontransplant patients (69% vs 45%, respectively; P = .111), although the difference was not statistically significant.


CONCLUSIONS
Further research is necessary to identify the factors contributing to increased rates of bleeding in renal transplant patients on IV heparin and to determine the ideal aPTT to appropriately balance anticoagulation in renal transplant patients.
PGY-2 Pharmacy Resident.
Theresa
T
Ringenberg
Transplant Clinical Pharmacist.
Heather
H
Desanto
Clinical Assistant Professor, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, New Brunswick, New Jersey; ; Cardiology Clinical Pharmacist.
Yekaterina
Y
Opsha
Ambulatory Care Clinical Pharmacist.
Jennifer
J
Costello
Assistant Director of Clinical Pharmacy Services, Pharmacy Department, St. Barnabas Medical Center, Livingston, New Jersey. Corresponding author: Theresa Ringenberg, PharmD, 5754 Wickershire Lane, St. Louis, MO 63129; phone: 314-680-5593; e-mail: tmringenberg@gmail.com.
Daryl
D
Schiller