Influence of aspirin on early allograft thrombosis and chronic allograft nephropathy following renal transplantation

Author:

Murphy G J1,Taha R1,Windmill D C1,Metcalfe M1,Nicholson M L1

Affiliation:

1. University Department of Surgery, Leicester General Hospital, Gwendolen Road, Leicester LE5 4PW, UK

Abstract

Abstract Background Primary thrombosis and chronic allograft nephropathy are important causes of early and late graft loss, respectively, following renal transplantation. This study examined the potential for aspirin therapy to reduce these complications. Methods A consecutive series of 105 cadaveric renal transplants treated with aspirin 150 mg daily for the first 3 months after transplantation was compared with an untreated historical control group (n = 121). Protocol needle-core biopsies were performed on all transplants in both groups at 1 week and 12 months after transplantation. Needle-core allograft biopsies were performed at 3, 6 and 12 months after transplantation, and serum creatinine was measured at each outpatient attendance for the duration of follow-up. Results There was a significantly lower rate of primary allograft thrombosis in patients treated with aspirin (none of 105) compared with that in the control group (six (5 per cent) of 121; P = 0·03). There were no differences in renal function or 2-year allograft survival between the two groups. Aspirin-treated patients had a lower incidence of chronic allograft nephropathy at 1 year than controls although this did not reach statistical significance (16 versus 26 per cent; P = 0·075). There were no major bleeding complications in either group in association with peptic ulcer disease or following renal transplant biopsy. Conclusion Aspirin reduced the rate of early graft thrombosis of renal transplants in this series but did not improve renal function or graft survival. A trend towards a lower rate of chronic allograft nephropathy was noted with aspirin treatment. These findings require confirmation in a prospective randomized trial.

Publisher

Oxford University Press (OUP)

Subject

Surgery

Reference34 articles.

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2. Vascular complications in 155 consecutive kidney transplantations;Nerstrom;Scand J Urol Nephrol,1972

3. Allograft renal vascular thrombosis: lack of increase with cyclosporine immunosuppression;Gruber;Transplantation,1989

4. Allograft renal vein thrombosis;Merion;Transplant Proc,1985

5. Increased incidence of renal allograft thrombosis under cyclosporin immunosuppression;Rigotti;Int Surg,1986

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