Management and Outcome After Early Renal Transplant Vein Thrombosis: A French Multicentre Observational Study of Real-Life Practice Over 24 Years

Overview

Journal Transpl Int

Specialty General Surgery

Date 2023 Apr 10

PMID 37035106

Authors

Ludivine Cambou

Clementine Millet

Nicolas Terrier

Paolo Malvezzi

Marc-Olivier Timsit

Dany Anglicheau

Lionel Badet

Emmanuel Morelon

Thomas Prudhomme

Nassim Kamar

Anne Lejay

Peggy Perrin

Charlotte Uro-Coste

Bruno Pereira

Anne Elisabeth Heng

Cyril Garrouste

Laurent Guy

Affiliations

Soon will be listed here.

Abstract

Early (<14 days) renal transplant vein thrombosis posttransplant (eRVTPT) is a rare but threatening complication. We aimed to assess eRVTPT management and the rate of functional renal transplantation. Of 11,172 adult patients who had undergone transplantation between 01/1997 and 12/2020 at 6 French centres, we identified 176 patients with eRVTPT (1.6%): 16 intraoperative (Group 1, G1) and 160 postoperative (Group 2, G2). All but one patient received surgical management. Patients in group G2 had at least one imaging test for diagnostic confirmation (N = 157, 98%). During the operative management of the G2 group, transplantectomy for graft necrosis was performed immediately in 59.1% of cases. In both groups, either of two techniques was preferred, namely, thrombectomy by renal venotomy or thrombectomy + venous anastomosis repair, with no difference in the functional graft rate (FGR) at hospital discharge ( = NS). The FGR was 62.5% in G1 and 8.1% in G2 ( < 0.001). Numerous complications occurred during the initial hospitalization: 38 patients had a postoperative infection (21.6%), 5 experienced haemorrhagic shock (2.8%), 29 exhibited a haematoma (16.5%), and 97 (55.1%) received a blood transfusion. Five patients died (2.8%). Our study confirms the very poor prognosis of early renal graft venous thrombosis.

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