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Observational Study
. 2023 Mar 23:36:10556.
doi: 10.3389/ti.2023.10556. eCollection 2023.

Management and Outcome After Early Renal Transplant Vein Thrombosis: A French Multicentre Observational Study of Real-Life Practice Over 24 Years

Ludivine Cambou  1 , Clémentine Millet  1 , Nicolas Terrier  2 , Paolo Malvezzi  3 , Marc-Olivier Timsit  4 , Dany Anglicheau  5 , Lionel Badet  6 , Emmanuel Morelon  7 , Thomas Prudhomme  8 , Nassim Kamar  9   3 , Anne Lejay  10 , Peggy Perrin  11   12   13 , Charlotte Uro-Coste  14 , Bruno Pereira  15 , Anne Elisabeth Heng  14 , Cyril Garrouste  14 , Laurent Guy  1
Affiliations
Observational Study

Management and Outcome After Early Renal Transplant Vein Thrombosis: A French Multicentre Observational Study of Real-Life Practice Over 24 Years

Ludivine Cambou et al. Transpl Int. .

Abstract

Early (<14 days) renal transplant vein thrombosis posttransplant (eRVTPT) is a rare but threatening complication. We aimed to assess eRVTPT management and the rate of functional renal transplantation. Of 11,172 adult patients who had undergone transplantation between 01/1997 and 12/2020 at 6 French centres, we identified 176 patients with eRVTPT (1.6%): 16 intraoperative (Group 1, G1) and 160 postoperative (Group 2, G2). All but one patient received surgical management. Patients in group G2 had at least one imaging test for diagnostic confirmation (N = 157, 98%). During the operative management of the G2 group, transplantectomy for graft necrosis was performed immediately in 59.1% of cases. In both groups, either of two techniques was preferred, namely, thrombectomy by renal venotomy or thrombectomy + venous anastomosis repair, with no difference in the functional graft rate (FGR) at hospital discharge (p = NS). The FGR was 62.5% in G1 and 8.1% in G2 (p < 0.001). Numerous complications occurred during the initial hospitalization: 38 patients had a postoperative infection (21.6%), 5 experienced haemorrhagic shock (2.8%), 29 exhibited a haematoma (16.5%), and 97 (55.1%) received a blood transfusion. Five patients died (2.8%). Our study confirms the very poor prognosis of early renal graft venous thrombosis.

Keywords: early vein thrombosis; kidney transplant; management; outcome; vein thrombosis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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