Maine Medical Center, Medical Education, Maine Medical Center Research Institute, Pharmacy
Kidney Transplantation, Retrospective Studies, Blood Coagulation, Anticoagulants, Health Services
Perioperative anticoagulation is standard for different surgical procedures in order to minimize the risk of thrombotic events. During renal transplantation, disturbances in hemostasis increase the likelihood for both thrombotic and hemorrhagic complications. This is detrimental to consider when balancing the prevention of thromboembolism including graft loss as well as major bleeding. In light of the literature lacking standardization, a perioperative anticoagulation protocol in renal transplantation was implemented at our institution in 2013. The primary purpose of this study is to determine the efficacy of the implemented protocol and further establish anticoagulation practices in the perioperative stage of renal transplantation. This study has been approved by the Institutional Review Board. Patients who are over 18 years old and have received a kidney transplant at our institution between March 2013 and July 2019 will be distinguished in virtue of a report generated from the electronic medical record system. Retrospective data will be de-identified and recorded via chart review, utilizing the data collection tool, REDCap. Select demographics that will be collected include: age, sex, body mass index, prior transplant loss due to thrombosis or other thrombotic events, delayed graft function, medications that increase the risk of bleeding or thrombosis risk, length of admission, previous dialysis, and previously diagnosed thrombophilic disorder. Additional data to be collected will include: time to therapeutic international normalized ratio (INR), time in therapeutic range post-transplant, and appropriateness of oral anticoagulation prescribed post-transplant in applicable patients. Primary outcomes are inclusive of: occurrence of graft thrombosis loss, major bleeding, clinically relevant bleeding, or occurrence of thrombotic events within 8 weeks and protocol adherence.
Ferreira, Sierra; Carlone, Brian; and Savic, Marizela, "Evaluation of a perioperative anticoagulation protocol in renal transplantation: a retrospective analysis." (2020). Costas T. Lambrew Research Retreat 2020. 56.