Venous thromboembolic complications after kidney and kidney-pancreas transplantation: a multivariate analysis.

Abstract:

BACKGROUND:We reviewed the incidence of and risk factors for venous thromboembolic complications in our population of kidney (KTx) and simultaneous kidney-pancreas transplant (SPK) recipients. METHODS:Information was collected retrospectively from a database on 1833 KTx and 276 SPK recipients who underwent transplant surgery between January 1985 and August 1995. RESULTS:The incidence of deep venous thrombosis (DVT) was 6.2% (n= 132), with significantly higher rates after SPK (18.1%) vs. KTx (4.5%) (P < 0.001). The number of DVT episodes was highest in the first month; 17.5% occurred during this time. For KTx recipients, early thrombotic events were more common on the side of the graft (P=0.03); however, after 1 month, no correlation existed between the side of the graft and the side of DVT. For SPK recipients, DVT tended to be more common on the side of the pancreas (57%) vs. the kidney (43%) (P=0.10). By multivariate analysis, risk factors for DVT were: age > 40 years (odds ratio [OR]=2.2, P < 0.001), diabetes mellitus (DM) (OR=2.0, P=0.002), previous DVT (OR=4.4, P=0.001), and SPK transplant (OR=2.8, P < 0.001). Pulmonary embolus (PE) was identified in 44 recipients (incidence, 2.1%) and was fatal in 13 (30%). The incidence was significantly higher in SPK (4.71%) vs. KTx recipients (1.69%) (P < 0.01). The risk of death from PE was 0.5% in KTx recipients and 1.37% in SPK recipients (P=0.08). Risk factors for PE included DM (OR=2.6, P=0.005) and recent DVT (OR=8.9, P=0.0001). CONCLUSIONS:Based on risk and extrapolating from the general surgical literature, our recommendations for prophylaxis against DVT are use of graduated compression stockings for all recipients and, in addition, low-dose heparin for moderate and high-risk recipients (previous DVT, SPK, age > 40 years, DM).

journal_name

Transplantation

journal_title

Transplantation

authors

Humar A,Johnson EM,Gillingham KJ,Sutherland DE,Payne WD,Dunn DL,Wrenshall LE,Najarian JS,Gruessner RW,Matas AJ

doi

10.1097/00007890-199801270-00015

subject

Has Abstract

pub_date

1998-01-27 00:00:00

pages

229-34

issue

2

eissn

0041-1337

issn

1534-6080

journal_volume

65

pub_type

杂志文章
  • Treatment and prevention of acute graft-versus-host disease with thalidomide in a rat model.

    abstract::We have investigated the immunosuppressive effects of thalidomide (Thal) in a bone marrow transplant (BMT) model for graft-versus-host disease (GVHD). Lewis rats received RT1-incompatible marrow transplants from ACI rats after total-body irradiation. Twenty-two of twenty-three rats with established severe acute GVHD w...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198605000-00018

    authors: Vogelsang GB,Hess AD,Gordon G,Santos GW

    更新日期:1986-05-01 00:00:00

  • Growth factor-induced mobilization of dendritic cells in kidney and liver of rhesus macaques: implications for transplantation.

    abstract::Hematopoietic growth factors (HGF) mobilize potential tolerogenic cells in transplant donors. Fms-like tyrosine kinase 3 ligand (Flt3L) mobilizes stem cells and dendritic cells (DCs) in human and nonhuman primate blood. Blood and renal and liver biopsies were obtained from untreated and Flt3L-mobilized rhesus macaques...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000255320.00061.e9

    authors: Morelli AE,Coates PT,Shufesky WJ,Barratt-Boyes SM,Fung JJ,Demetris AJ,Thomson AW

    更新日期:2007-03-15 00:00:00

  • Nosocomial Pneumocystis jirovecii pneumonia: lessons from a cluster in kidney transplant recipients.

    abstract:BACKGROUND:Pneumocystis jirovecii pneumonia (PJP) is an important infection-related complication, whose mode of transmission remains uncertain. METHODS:We investigated a nosocomial cluster of 14 PJP cases (11 confirmed and 3 probable) in kidney transplant recipients using epidemiological and genotyping methods. RESUL...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e3182384b57

    authors: Phipps LM,Chen SC,Kable K,Halliday CL,Firacative C,Meyer W,Wong G,Nankivell BJ

    更新日期:2011-12-27 00:00:00

  • Quantitative polymerase chain reaction profiling of immunomarkers in rejecting kidney allografts for predicting response to steroid treatment.

    abstract:BACKGROUND:Steroid-resistant acute rejection is a risk factor for inferior renal allograft outcome. METHODS:From 873 kidney transplant recipients (1995-2005), 108 patients with a first rejection episode were selected for study using strict inclusion criteria and clinical endpoint definition. We aimed to predict respon...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e31825db651

    authors: Rekers NV,Bajema IM,Mallat MJ,Zuidwijk K,Anholts JD,Goemaere N,Haasnoot GW,van Groningen MC,van Kooten C,de Fijter JW,Claas FH,Eikmans M

    更新日期:2012-09-27 00:00:00

  • Pulmonary and blood stream infections in adult living donor and cadaveric liver transplant patients.

    abstract:BACKGROUND:Infectious complications occur in approximately 50% of cadaveric liver transplant (CDLT) recipients. Living-donor liver transplantation (LDLT) is an established alternative to shorten the waiting time. Currently, the incidence of pulmonary infections after LDLT and the microbiologic causes are unknown. In th...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e31816f61a6

    authors: Saner FH,Olde Damink SW,Pavlakovic G,van den Broek MA,Rath PM,Sotiropoulos GC,Radtke A,Canbay A,Paul A,Nadalin S,Malagó M,Broelsch CE

    更新日期:2008-06-15 00:00:00

  • The importance of static lung inflation during organ storage: the impact of varying ischemic intervals in a double lung rat transplantation model.

    abstract::To determine the importance of static lung inflation during storage, graft performance was evaluated at different levels of intratracheal pressure and varying ischemic intervals. Lewis rat lungs were perfused with low-potassium Euro-Collins and stored for 4 or 8 hr either in atelectasis (4 hr: group I; 8 hr: group IV,...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199612270-00004

    authors: Hausen B,Ramsamooj R,Hewitt CW,Schroder F,Beuke M,Poets CF,Schafers HJ

    更新日期:1996-12-27 00:00:00

  • Cold-storage preservation of the canine and rat pancreas prior to islet isolation.

    abstract::Cold-storage preservation of the canine pancreas prior to islet isolation has previously been noted to reduce the intrasplenic islet autograft success rate; but the mechanism of this deleterious effect has not been determined. We undertook a study in both outbred dogs and Lewis (RT1-1) rats to determine the influence ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198901000-00007

    authors: Munn SR,Kaufman DB,Field MJ,Viste AB,Sutherland DE

    更新日期:1989-01-01 00:00:00

  • Thromboembolism in heart transplantation: role of prothrombin G20210A and factor V Leiden.

    abstract:BACKGROUND:Thromboembolism has been reported as a frequent complication after cardiac transplantation. Many risk factors for thrombosis may explain this, such as metabolic alterations and the use of cyclosporine. In the general population, two single nucleotide polymorphisms (SNPs), factor V Leiden and prothrombin G202...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000170545.42790.6f

    authors: Miriuka SG,Langman LJ,Evrovski J,Miner SE,Kozuszko S,D'Mello N,Delgado DH,Wong BY,Ross HJ,Cole DE

    更新日期:2005-09-15 00:00:00

  • The extent and predictors of waiting time geographic disparity in kidney transplantation in the United States.

    abstract:BACKGROUND:Waiting time to deceased donor kidney transplant varies greatly across the United States. This variation violates the final rule, a federal mandate, which demands geographic equity in organ allocation for transplantation. METHODS:Retrospective analysis of the United States Renal Data System and United Netwo...

    journal_title:Transplantation

    pub_type: 杂志文章,多中心研究

    doi:10.1097/01.tp.0000438623.89310.dc

    authors: Davis AE,Mehrotra S,McElroy LM,Friedewald JJ,Skaro AI,Lapin B,Kang R,Holl JL,Abecassis MM,Ladner DP

    更新日期:2014-05-27 00:00:00

  • In Vivo Costimulation Blockade-Induced Regulatory T Cells Demonstrate Dominant and Specific Tolerance to Porcine Islet Xenografts.

    abstract:BACKGROUND:Although islet xenotransplantation is a promising therapy for type 1 diabetes, its clinical application has been hampered by cellular rejection and the requirement for high levels of immunosuppression. The aim of this study was to determine the role of Foxp3 regulatory T (Treg) cells in costimulation blockad...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000001482

    authors: Wu J,Hu M,Qian YW,Hawthorne WJ,Burns H,Liuwantara D,Alexander SI,Yi S,O'Connell PJ

    更新日期:2017-07-01 00:00:00

  • The economic benefit of allocation of kidneys based on cross-reactive group matching.

    abstract:BACKGROUND:Recently the United Network for Organ Sharing (UNOS) began a pilot study to evaluate prospectively the merits of an allocation of cadaveric kidneys based on broader classes of HLA antigens, called cross-reactive groups (CREG). The objectives of the pilot study consider patient outcomes, but not the potential...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200008150-00024

    authors: Hollenbeak CS,Woodward RS,Cohen DS,Lowell JA,Singer GG,Tesi RJ,Howard TK,Mohanakumar T,Brennan DC,Schnitzler MA

    更新日期:2000-08-15 00:00:00

  • Magnetic resonance-defined perinephric edema after clinical islet transplantation: a benign finding associated with mild renal impairment.

    abstract::Immunosuppression with sirolimus and low-dose tacrolimus has facilitated successful clinical islet transplantation (CIT). Because the long-term effects on the kidney are unknown and immunosuppressant drugs can be nephrotoxic, CIT is currently restricted to patients with preserved renal function or a functioning renal ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000134971.15093.07

    authors: Senior PA,Shapiro AM,Ackerman TE,Ryan EA,Paty BW,Bhargava R

    更新日期:2004-09-27 00:00:00

  • Effects of tacrolimus on hyperlipidemia after successful renal transplantation: a Southeastern Organ Procurement Foundation multicenter clinical study.

    abstract:BACKGROUND:Tacrolimus has been shown to have a less adverse effect on the lipid profiles of transplant patients when the drug is started as induction therapy. In order to determine the effect tacrolimus has on lipid profiles in stable cyclosporine-treated renal transplant patients with established hyperlipidemia, a ran...

    journal_title:Transplantation

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1097/00007890-199801150-00017

    authors: McCune TR,Thacker LR II,Peters TG,Mulloy L,Rohr MS,Adams PA,Yium J,Light JA,Pruett T,Gaber AO,Selman SH,Jonsson J,Hayes JM,Wright FH Jr,Armata T,Blanton J,Burdick JF

    更新日期:1998-01-15 00:00:00

  • Adherence to Lamivudine after an early withdrawal of hepatitis B immune globulin plays an important role in the long-term prevention of hepatitis B virus recurrence.

    abstract::Lamivudine combined with hepatitis B immune globulin (HBIg) is the standard of care for preventing the recurrence hepatitis B virus after liver transplant. To determine the risk of hepatitis B virus (HBV) recurrence after early withdrawal of HBIg in patients receiving lamivudine maintenance therapy, 20 patients receiv...

    journal_title:Transplantation

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/01.tp.0000277289.23677.0a

    authors: Buti M,Mas A,Prieto M,Casafont F,González A,Miras M,Herrero JI,Jardi R,Esteban R

    更新日期:2007-09-15 00:00:00

  • Relevant factors to psychological status of donors before living-related liver transplantation.

    abstract:BACKGROUND:While previous surveys have demonstrated the psychological impact on living-related liver transplantation (LRLT) donors, such as anxiety, depression, ambivalence and anger, the details regarding the relevant factors that affect donors' psychological status have not been well described. METHODS:To evaluate e...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000287455.70815.9e

    authors: Hayashi A,Noma S,Uehara M,Kuwabara H,Tanaka S,Furuno Y,Hayashi T

    更新日期:2007-11-27 00:00:00

  • Neutrophilic tubulitis as a marker for urinary tract infection in renal allograft biopsies with C4d deposition.

    abstract:BACKGROUND:Neutrophilic tubulitis accompanied by intratubular neutrophil clusters in the renal allograft is a surrogate marker for urinary tract infection (UTI). Overlapping histologic findings can occur in antibody-mediated rejection, which is characterized by peritubular capillary (PTC) deposition of C4d. This study ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e31819ca304

    authors: Gupta G,Shapiro R,Girnita A,Batal I,McCauley J,Basu A,Tan H,Randhawa P

    更新日期:2009-04-15 00:00:00

  • Zero-Time Renal Transplant Biopsies: A Comprehensive Review.

    abstract::Zero-time kidney biopsies, obtained at time of transplantation, are performed in many transplant centers worldwide. Decisions on kidney discard, kidney allocation, and choice of peritransplant and posttransplant treatment are sometimes based on the histological information obtained from these biopsies. This comprehens...

    journal_title:Transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/TP.0000000000001018

    authors: Naesens M

    更新日期:2016-07-01 00:00:00

  • First in man renal transplantation after ex vivo normothermic perfusion.

    abstract:BACKGROUND:Normothermic perfusion is an alternative but little studied method of organ preservation. Herein, we report the first case of ex vivo normothermic renal transplant perfusion in man. METHODS:The 62-year-old extended criteria donor died of an intracranial hemorrhage and had undergone cardiopulmonary resuscita...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e31822d4e04

    authors: Hosgood SA,Nicholson ML

    更新日期:2011-10-15 00:00:00

  • Identification of kidneys subjected to preretrieval warm ischemic injury by simultaneous monitoring of glomerular filtration and perfusate flow during hypothermic perfusion preservation.

    abstract:BACKGROUND:Historically, ex vivo physiological evaluation of cadaveric renal allografts has been limited to assessing perfusate flow (PF) during hypothermic perfusion preservation (HPP). Using a small animal model, we have previously described a method for continuous monitoring of glomerular filtration rate (GFR) durin...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199911270-00006

    authors: Inman SR,Osgood RW,Plott WK,Richardson BF,Lewis RM

    更新日期:1999-11-27 00:00:00

  • Evidence that macrophages are required for T-cell infiltration and rejection of fetal pig pancreas xenografts in nonobese diabetic mice.

    abstract:BACKGROUND:Host macrophages are abundant within fetal pig pancreas xenografts undergoing rejection, but their role is unknown. Therefore, we examined the effect of host macrophage depletion on xenograft rejection. METHODS:Nonobese diabetic (NOD) mice were given clodronate-loaded liposomes intravenously to deplete macr...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199812150-00002

    authors: Fox A,Koulmanda M,Mandel TE,van Rooijen N,Harrison LC

    更新日期:1998-12-15 00:00:00

  • Expression of MRP2 and MRP3 during liver regeneration after 90% partial hepatectomy in rats.

    abstract:BACKGROUND:Small-for-size grafts often cause persistent conjugated hyperbilirubinemia in the recipient after adult-to-adult living donor liver transplantation, but the cause has not yet been clarified. In physiologic status, bilirubin is excreted from hepatocytes to the bile canaliculus by means of multidrug resistance...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.TP.0000089234.93366.6D

    authors: Chang TH,Hakamada K,Toyoki Y,Tsuchida S,Sasaki M

    更新日期:2004-01-15 00:00:00

  • The role of graft and host accommodation in a hamster-to-rat cardiac transplantation model.

    abstract:BACKGROUND:We evaluated the importance and mechanism of graft and host accommodation in hamster-to-rat cardiac xenotransplantation models. METHODS:To evaluate graft accommodation, accommodated hamster grafts (Group 2) were transplanted to naïve host rats treated with FK506, and compared with naïve hamster grafts (Grou...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000296030.88283.92

    authors: Komori K,Fuchimoto Y,Morikawa Y,Obara H,Kawachi S,Tanabe M,Hoshino K,Shimazu M,Matsuzaki Y,Kitajima M

    更新日期:2008-01-15 00:00:00

  • Survival benefit of cardiopulmonary bypass support in bilateral lung transplantation for emphysema patients.

    abstract:BACKGROUND:This study is designed to examine a possible association of cardiopulmonary bypass (CPB) support and outcome of lung transplantation in a well-balanced group of emphysema patients. METHODS:We performed a retrospective analysis of 62 consecutive primary bilateral lung transplantations for emphysema. Risk fac...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200205270-00017

    authors: de Boer WJ,Hepkema BG,Loef BG,van der Bij W,Verschuuren EA,de Vries HJ,Lems SP,Ebels T

    更新日期:2002-05-27 00:00:00

  • Long-term persistence of transferred PPD-reactive T cells after allogeneic bone marrow transplantation.

    abstract::T cells play an important role in protective immunity against tuberculosis. As patients are not reimmunized with BCG after BMT, the question arises as to whether PPD-specific memory T cells are transferred from the marrow donor to the recipient and persist in the long-term. We studied long-term survivors of non-T cell...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199301000-00014

    authors: Rouleau M,Senik A,Leroy E,Vernant JP

    更新日期:1993-01-01 00:00:00

  • Selective inhibition of vascular cell adhesion molecule-1 expression by verapamil in human vascular endothelial cells.

    abstract::Up-regulated expression of adhesion molecules on vascular endothelial cells (ECs) is an initial event in leukocyte adhesion to ECs, which is a crucial step in the process of inflammatory or immune reaction leading to organ transplant rejection. Verapamil and other calcium channel blockers have been reported to improve...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199703150-00024

    authors: Yamaguchi M,Suwa H,Miyasaka M,Kumada K

    更新日期:1997-03-15 00:00:00

  • N-acetylcysteine ameliorates reperfusion injury after warm hepatic ischemia.

    abstract::Glutathione is important in cellular defense against oxidative stress. We postulated that administration of N-acetylcysteine (NAC), a glutathione precursor, might help maintain or replenish hepatic glutathione stores, thereby reducing reperfusion injury in liver grafts after warm ischemia. Eighteen pigs were subjected...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199501150-00002

    authors: Fukuzawa K,Emre S,Senyuz O,Acarli K,Schwartz ME,Miller CM

    更新日期:1995-01-15 00:00:00

  • Randomized trial to evaluate the clinical benefits of serum alpha-glutathione S-transferase concentration monitoring after liver transplantation.

    abstract:BACKGROUND:An increase in serum alpha-glutathione S-transferase concentration (GST) has been shown to be a more sensitive and specific marker of hepatocellular damage than equivalent increases in transaminase activities. A randomized clinical trial of 60 liver transplants in 49 patients was carried out to assess the cl...

    journal_title:Transplantation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00007890-199711270-00013

    authors: Hughes VF,Trull AK,Gimson A,Friend PJ,Jamieson N,Duncan A,Wight DG,Prevost AT,Alexander GJ

    更新日期:1997-11-27 00:00:00

  • The urine protein to creatinine ratio (P/C) as a predictor of 24-hour urine protein excretion in renal transplant patients.

    abstract:BACKGROUND:The purpose of this study was to examine the utility of the random urine protein to creatinine ratio (P/C) in evaluation and longitudinal management of proteinuria in adult renal transplant recipients with or without overt nephropathy in an outpatient clinic. METHODS:A total of 289 adult renal transplant re...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200110270-00021

    authors: Torng S,Rigatto C,Rush DN,Nickerson P,Jeffery JR

    更新日期:2001-10-27 00:00:00

  • The Impact of Liver Graft Injury on Cancer Recurrence Posttransplantation.

    abstract::Liver transplantation is the most effective treatment for selected patients with hepatocellular carcinoma. However, cancer recurrence, posttransplantation, remains to be the critical issue that affects the long-term outcome of hepatocellular carcinoma recipients. In addition to tumor biology itself, increasing evidenc...

    journal_title:Transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/TP.0000000000001844

    authors: Li CX,Man K,Lo CM

    更新日期:2017-11-01 00:00:00

  • Phenotypic variations in resting and activated levels of ICAM-1 expression by cultured human aortic endothelial cells.

    abstract::ICAM-1 is an inducible glycoprotein important in the adhesion, activation, and transmigration of circulating leukocytes across the vascular endothelial monolayer, and it likely plays a key role in the allogeneic response. To determine the reproducibility and significance of variations in resting levels of cell surface...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199410270-00015

    authors: Everett JP,Shipley GD,Mauck KA,Wagner CR,Morris TE,Hosenpud JD

    更新日期:1994-10-27 00:00:00