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[Antiphospholipid antibody syndrome: a priori a contraindication to kidney transplantation?]
- Source :
- Aktuelle Urologie. 38(2)
- Publication Year :
- 2007
-
Abstract
- The antiphospholipid antibody syndrome (APLS) is characterised by the presence of antiphospholipid antibodies in association with thrombotic disorders of the arterial and/or venous system, spontaneous abortion and thrombocytopenia. Several studies have shown that end-stage renal disease patients with APLS are at extremely high risk for graft thrombosis and graft loss after kidney transplantation.We report on the treatment and clinical courses of 6 APLS renal transplant patients.Of 3 patients treated with low-dose subcutaneous heparin two had early graft loss due to venous graft thrombosis; of those patients treated by systemic heparin (PTT goal 45-55 s) and followed by coumadin (INR 2.5-3.0) only one had early graft loss whereas 2 grafts are doing well 2 years post-transplant.Our experience as well as recently published data suggest that kidney transplantation can be performed successfully in APLS patients if anticoagulation therapy is performed consistently. A general APL antibody screening prior to kidney transplantation does not seem to be justified at present. A prospective, randomised multicenter study is warranted to evaluate the management of these patients with respect to intensity, type and duration of anticoagulation therapy.
Details
- Language :
- German
- ISSN :
- 00017868
- Volume :
- 38
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Aktuelle Urologie
- Accession number :
- edsair.pmid..........875efa9398c38f74ac0ab513e76907b3