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Aktuelle Urol. 2007 Mar;38(2):132-6.

[Antiphospholipid antibody syndrome: a priori a contraindication to kidney transplantation?].

[Article in German]

Author information

1
Urologische Klinik und Poliklinik sowie Medizinische Klinik, Abteilung Nephrologie mit Transplantationszentrum der Bayerischen Julius-Maximilians-Universit├Ąt W├╝rzburg. rubenwolf_p@klinik.wuerzburg.de

Abstract

BACKGROUND:

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.

MATERIAL AND METHODS:

We report on the treatment and clinical courses of 6 APLS renal transplant patients.

RESULTS:

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.

CONCLUSION:

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.

PMID:
17390275
DOI:
10.1055/s-2006-944306
[Indexed for MEDLINE]

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