Thromboembolism in kidney transplant patients

An increased incidence of deep vein thrombosis in kidney transplant recipients was first reported from Oxford by Richard Allen in 1987.This is confirmed in a single centre study from Montreal over an 11 year period, where they used a nested case control study comparing patients with and without thromboembolism. Amongst 930 kidney transplant recipients there were 68 thromboembolic events. The standardised incidence ratio of thromboembolism in kidney transplant recipients was 7.9 compared with the general population over the duration of follow up. This 8-fold increased risk occurs particularly in the first post-transplant year or during any subsequent hospitalisation, but was also associated with the use of sirolimus and steroids for immunosuppression and malignancy in the transplant patient.

It is now generally accepted that there is an increased risk of deep vein thrombosis, sometimes associated with pulmonary embolism, in kidney transplant recipients particularly in the first year. Most units would regard prophylaxis against thromboembolism as being necessary in all our kidney transplant recipients and especially if they are being readmitted for any reason, and particularly surgery.