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Master's Dissertation
DOI
https://doi.org/10.11606/D.5.2021.tde-07012022-143324
Document
Author
Full name
Julia Maimone Beatrice
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2021
Supervisor
Committee
Carneiro, Jorge David Aivazoglou (President)
D'Amico, Elbio Antonio
Odone Filho, Vicente
Paula, Erich Vinicius de
Title in Portuguese
Trombose de enxerto pós transplante renal: estudo dos benefícios e riscos da tromboprofilaxia
Keywords in Portuguese
Anticoagulantes
Hemorragia
Pediatria
Transplante de rim
Trombofilia
Trombose
Abstract in Portuguese
Objetivo: Descrever as características demográficas e os fatores de risco trombóticos em receptores de transplante renal pediátrico, assim como a incidência de trombose de enxerto pós transplante e discutir o papel da tromboprofilaxia farmacológica. Métodos: Este estudo retrospectivo avaliou 96 transplantes renais pediátricos entre 2008-2017 em um único hospital. Para análise, os pacientes foram divididos em dois grupos: crianças que não receberam tromboprofilaxia após o transplante e aquelas que receberam. Relatamos suas características demográficas, clínicas e laboratoriais, comparando a incidência de trombose do enxerto e complicações hemorrágicas entre os grupos. Resultados: Quarenta e nove pacientes (51%) receberam tromboprofilaxia com heparina e aspirina conforme o protocolo. Trombose do enxerto ocorreu em cinco pacientes que não receberam tromboprofilaxia (5,2%) em comparação com nenhum no grupo que recebeu (p = 0,025). Em todos os pacientes, a trombose do enxerto renal resultou na perda precoce do enxerto. Treze pacientes tiveram complicações hemorrágicas, sendo a maioria graves (53,8%) e sete não estavam relacionados à tromboprofilaxia farmacológica (ou não receberam tromboprofilaxia ou tiveram sangramento anterior ao uso de heparina). Não houve diferença significativa na taxa de complicações hemorrágicas entre os grupos (p = 0,8278). Conclusões: A incidência de trombose do enxerto renal foi de 5,2%. Trombose ainda é uma causa importante de perda precoce do enxerto. A tromboprofilaxia foi associada à redução da trombose do enxerto sem aumento do risco de sangramento
Title in English
Graft thrombosis pos kidney transplantation: study of benefits and risks of thromboprophylaxis
Keywords in English
Anticoagulants
Hemorrhage
Kidney transplantation
Pediatrics
Thrombophilia
Thrombosis
Abstract in English
Objective: To describe the demographic characteristics and thrombotic risk factors in pediatric renal transplant recipients, determining the incidence of renal graft thrombosis as well as discuss the role of pharmacological thromboprophylaxis. Methods: This retrospective study reviewed 96 pediatric renal transplantations between 2008-2017 in a single hospital. Patients were assigned one of two groups: children who did not receive thromboprophylaxis after transplantation and those who did. We reported their demographic, clinical, and laboratory characteristics, comparing the incidence of graft thrombosis and hemorrhagic complications between the groups. Results: Forty-nine patients (51%) received thromboprophylaxis with heparin and aspirin as per protocol. Thrombosis occurred in five patients who did not receive thromboprophylaxis (5,2%) compared to none in the group that did (p=0.025). In all patients renal graft thrombosis resulted in early graft loss. Thirteen patients had hemorrhagic complications, of which most were major bleeding (53.8%) and seven were unrelated to pharmacological thromboprophylaxis (either did not receive thromboprophylaxis or had bleeding prior thromboprophylaxis). There was no significant difference in the rate of hemorrhagic complications between groups (p=0.8278). Conclusions: Rate of renal graft thrombosis was 5.2%. Thrombosis remains an important cause of early graft loss. Thromboprophylaxis was associated with reduction of graft thrombosis without increased risk of bleeding
 
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Publishing Date
2022-01-18
 
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