Original Report: Transplantation
Venous Thromboembolism and the Risk of Death and Graft Loss in Kidney Transplant RecipientsLam N.N.a · Garg A.X.b,c,g · Knoll G.A.d, e · Kim S.J.f, g · Lentine K.L.i, j · McArthur E.g · Naylor K.L.g, h · Bota S.E.g · Sood M.M.d,e,g
aDepartment of Medicine, Division of Nephrology, University of Alberta, Edmonton, AB, bDepartment of Medicine, Division of Nephrology, Western University, and cDepartment of Epidemiology and Biostatistics, Western University, London, ON, dDepartment of Medicine, Division of Nephrology, University of Ottawa, and eClinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, fDepartment of Medicine, Division of Nephrology, University of Toronto, gInstitute for Clinical Evaluative Sciences (ICES), and hInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; iCenter for Abdominal Transplantation, Saint Louis University, and jDepartment of Medicine, Division of Nephrology, Saint Louis University School of Medicine, St. Louis, MO, USA
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Article / Publication Details
Background: The implications of venous thromboembolism (VTE) for morbidity and mortality in kidney transplant recipients are not well described. Methods: We conducted a retrospective study using linked healthcare databases in Ontario, Canada to determine the risk and complications of VTE in kidney transplant recipients from 2003 to 2013. We compared the incidence rate of VTE in recipients (n = 4,343) and a matched (1:4) sample of the general population (n = 17,372). For recipients with evidence of a VTE posttransplant, we compared adverse clinical outcomes (death, graft loss) to matched (1:2) recipients without evidence of a VTE posttransplant. Results: During a median follow-up of 5.2 years, 388 (8.9%) recipients developed a VTE compared to 254 (1.5%) in the matched general population (16.3 vs. 2.4 events per 1,000 person-years; hazard ratio [HR] 7.1, 95% CI 6.0-8.4; p < 0.0001). Recipients who experienced a posttransplant VTE had a higher risk of death (28.5 vs. 11.2%; HR 4.1, 95% CI 2.9-5.8; p < 0.0001) and death-censored graft loss (13.1 vs. 7.5%; HR 2.3, 95% CI 1.4-3.6; p = 0.0006) compared to matched recipients who did not experience a posttransplant VTE. Conclusions: Kidney transplant recipients have a sevenfold higher risk of VTE compared to the general population with VTE conferring an increased risk of death and graft loss.
© 2017 S. Karger AG, Basel
Article / Publication Details
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