Identification of Risk Factors for Vascular Thrombosis May Reduce Early Renal Graft Loss: A Review of Recent Literature

Renal graft survival has improved over the past years, mainly owing to better immunosuppression. Vascular thrombosis, though rare, therefore accounts for up to one third of early graft loss. We assess current literature on transplantation, identify thrombosis risk factors, and discuss means of avoid...

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Main Authors: Anna Krarup Keller, Troels Munch Jorgensen, Bente Jespersen
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Journal of Transplantation
Online Access:http://dx.doi.org/10.1155/2012/793461
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author Anna Krarup Keller
Troels Munch Jorgensen
Bente Jespersen
author_facet Anna Krarup Keller
Troels Munch Jorgensen
Bente Jespersen
author_sort Anna Krarup Keller
collection DOAJ
description Renal graft survival has improved over the past years, mainly owing to better immunosuppression. Vascular thrombosis, though rare, therefore accounts for up to one third of early graft loss. We assess current literature on transplantation, identify thrombosis risk factors, and discuss means of avoiding thrombotic events and saving thrombosed grafts. The incidence of arterial thrombosis was reported to 0.2–7.5% and venous thrombosis 0.1–8.2%, with the highest incidence among children and infants, and the lowest in living donor reports. The most significant risk factors for developing thrombosis were donor-age below 6 or above 60 years, or recipient-age below 5-6 years, per- or postoperative hemodynamic instability, peritoneal dialysis, diabetic nephropathy, a history of thrombosis, deceased donor, or >24 hours cold ischemia. Multiple arteries were not a risk factor, and a right kidney graft was most often reported not to be. Given the thrombosed kidney graft is diagnosed in time, salvage is possible by urgent reoperation and thrombectomy. Despite meticulous attentions to reduce thrombotic risk factors, thrombosis cannot be entirely prevented and means to an early detection of this complication is desirable in order to save the kidneys through prompt reoperation. Microdialysis may be a new tool for this.
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spelling doaj-art-c8e19482b84642e08d67281398c3aa0e2025-08-20T02:19:41ZengWileyJournal of Transplantation2090-00072090-00152012-01-01201210.1155/2012/793461793461Identification of Risk Factors for Vascular Thrombosis May Reduce Early Renal Graft Loss: A Review of Recent LiteratureAnna Krarup Keller0Troels Munch Jorgensen1Bente Jespersen2Institute of Clinical Medicine, Aarhus University, DenmarkDepartment of Urology, Aarhus University Hospital, Brendstrupgaardsvej 100, Skejby, 8200 Aarhus N, DenmarkDepartment of Nephrology, Aarhus University Hospital, Brendstrupgaardsvej 100, Skejby, 8200 Aarhus N, DenmarkRenal graft survival has improved over the past years, mainly owing to better immunosuppression. Vascular thrombosis, though rare, therefore accounts for up to one third of early graft loss. We assess current literature on transplantation, identify thrombosis risk factors, and discuss means of avoiding thrombotic events and saving thrombosed grafts. The incidence of arterial thrombosis was reported to 0.2–7.5% and venous thrombosis 0.1–8.2%, with the highest incidence among children and infants, and the lowest in living donor reports. The most significant risk factors for developing thrombosis were donor-age below 6 or above 60 years, or recipient-age below 5-6 years, per- or postoperative hemodynamic instability, peritoneal dialysis, diabetic nephropathy, a history of thrombosis, deceased donor, or >24 hours cold ischemia. Multiple arteries were not a risk factor, and a right kidney graft was most often reported not to be. Given the thrombosed kidney graft is diagnosed in time, salvage is possible by urgent reoperation and thrombectomy. Despite meticulous attentions to reduce thrombotic risk factors, thrombosis cannot be entirely prevented and means to an early detection of this complication is desirable in order to save the kidneys through prompt reoperation. Microdialysis may be a new tool for this.http://dx.doi.org/10.1155/2012/793461
spellingShingle Anna Krarup Keller
Troels Munch Jorgensen
Bente Jespersen
Identification of Risk Factors for Vascular Thrombosis May Reduce Early Renal Graft Loss: A Review of Recent Literature
Journal of Transplantation
title Identification of Risk Factors for Vascular Thrombosis May Reduce Early Renal Graft Loss: A Review of Recent Literature
title_full Identification of Risk Factors for Vascular Thrombosis May Reduce Early Renal Graft Loss: A Review of Recent Literature
title_fullStr Identification of Risk Factors for Vascular Thrombosis May Reduce Early Renal Graft Loss: A Review of Recent Literature
title_full_unstemmed Identification of Risk Factors for Vascular Thrombosis May Reduce Early Renal Graft Loss: A Review of Recent Literature
title_short Identification of Risk Factors for Vascular Thrombosis May Reduce Early Renal Graft Loss: A Review of Recent Literature
title_sort identification of risk factors for vascular thrombosis may reduce early renal graft loss a review of recent literature
url http://dx.doi.org/10.1155/2012/793461
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AT bentejespersen identificationofriskfactorsforvascularthrombosismayreduceearlyrenalgraftlossareviewofrecentliterature