Prophylactic Anticoagulation Reduces the Risk of Kidney Graft Venous Thrombosis in Recipients From Uncontrolled Donation After Circulatory Death Donors With High Renal Resistive Index

• Published in: Transplantation direct 2024-06, Vol.10 (6), p.e1649
• Main Authors: Molina, Maria, Fernández-Ruiz, Mario, Gonzalez, Esther, Cabrera, Jimena, Praga, Manuel, Rodriguez, Alfredo, Tejido-Sánchez, Angel, Medina-Polo, Jose, Mateos, Alonso, Rubio-Chacón, Carlos, Sanchez, Angel, Pla, Ana, Andrés, Amado
• Format: Article
• Language: English
• Subjects: Organ Donation and Procurement
• ISSN: 2373-8731; 2373-8731
• DOI: 10.1097/TXD.0000000000001649

Uncontrolled donation after circulatory death (uDCD) increases organ availability for kidney transplantation (KT) at the expense of a higher risk of primary graft nonfunction (PNF). At least half of the cases of PNF are secondary to graft venous thrombosis. The potential benefit from prophylactic anticoagulation in this scenario remains unclear. In this single-center retrospective study we compared 2 consecutive cohorts of KT from uDCD with increased (≥0.8) renal resistive index (RRI) in the Doppler ultrasound examination performed within the first 24-72 h after transplantation: 36 patients did not receive anticoagulation ("nonanticoagulation group") and 71 patients underwent prophylactic anticoagulation until normalization of RRI in follow-up Doppler examinations ("anticoagulation group"). Anticoagulation was initiated at a median of 2 d (interquartile range, 2-3) after transplantation and maintained for a median of 12 d (interquartile range, 7-18). In 4 patients (5.6%), anticoagulation had to be prematurely stopped because of the development of a hemorrhagic complication. In comparison with the nonanticoagulation group, recipients in the anticoagulation group had a lower 2-wk cumulative incidence of graft venous thrombosis (19.4% versus 0.0%;