The epidemiology of early deep vein thrombosis in kidney transplant recipients

Abstract

Background: Because kidney transplant recipients may be at increased risk for deep vein thrombosis (DVT) following transplantation, we investigated the incidence, risk factors, treatments and outcomes of early DVT among kidney transplant recipients. Methods: An observational, single-centre cohort study was conducted among adult kidney transplant recipients from Jan. 1, 2005, to Dec. 31, 2016 with 1-year followup. Time to DVT was assessed using the Kaplan–Meier method. Cox proportional hazards and linear regression models were used to analyze risk factors for and outcomes of DVT. Results: The cumulative incidence of DVT was 4.25% at 3 months after transplant. In multivariable analysis, the use of depleting induction agents (hazard ratio [HR] 2.13, 95% confidence interval [CI] 1.05–4.35]), white recipient race (HR 1.84. 95% CI 1.08–3.12), the use of kidneys from expanded criteria donors (HR 2.13, 95% CI 1.05–4.32) and lower recipient body mass index (HR 0.95, 95% CI 0.91–1.00) increased the risk for early DVT. Peritransplant DVT prophylaxis was not associated with early DVT. Early DVT was not associated with reduced graft function, death, graft failure or first hospital readmission. Conclusion: Risk factors for early DVT in our cohort of kidney transplant recipients included white recipient race, use of depleting agents, lower recipient body mass index and use of expanded criteria donors. As practice patterns of donor and recipient selection in kidney transplantation evolve, the results of this study may aid in perioperative risk assessments and decision-making about the use of DVT prophylaxis.