Direct Oral Anticoagulants Vs Vitamin-K Antagonists in Solid Organ Transplant Recipients: A Systematic Review and Meta-analysis

Overview

Journal Pak J Med Sci

Specialty General Medicine

Date 2024 Jul 2

PMID 38952515

Authors

Chujun He

Chunchun Yao

Affiliations

Soon will be listed here.

Abstract

Objective: Oure review aimed to examine evidence on the safety and efficacy of direct oral anticoagulants (DOAC) vs Vitamin K antagonists (VKA) in patients with solid organ transplants.

Methods: PubMed, Embase, and Web of Science libraries were searched from inception to 25 November 2023 for all studies comparing DOAC with VKA in solid organ recipients.

Results: Nine studies were included with patients who had undergone kidney, heart, or liver transplants. Meta-analysis showed that patients receiving DOAC had a significantly reduced risk of composite bleeding as compared to those with VKA (RR: 0.45 95% CI: 0.30, 0.68 I=25%). However, the risk of major bleeding was not significantly different between the two groups (RR: 0.76 95% CI: 0.40, 1.42 I=37%). Pooled analysis showed that the risk of VTE (RR: 0.90 95% CI: 0.72, 1.13 I=0%) and ischemic stroke (RR: 0.87 95% CI: 0.39, 1.94 I=12%) was not significantly different between DOAC and VKA groups.

Conclusion: Limited data shows that DOAC are safe and effective in patients with solid organ transplants. The overall risk of bleeding may be reduced with the use of DOAC. There is a need for randomized controlled trials comparing DOAC and VKA in such patients to obtain high-quality evidence.

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