Venous Thromboembolic Complications after Kidney and Kidney-Pancreas Transplantation: a Multivariate Analysis

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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%)(PP=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,PP=0.002), previous DVT (OR=4.4,P=0.001), and SPK transplant (OR=2.8,PPP=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).

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