학술논문

Risk factors for postoperative bleeding in ABO-incompatible kidney transplantation.
Document Type
Article
Source
Clinical Transplantation. Apr2015, Vol. 29 Issue 4, p365-372. 8p.
Subject
*KIDNEY transplantation
*HEMORRHAGE
*TRANSPLANTATION of organs, tissues, etc.
*NEPHROLOGY
*URINARY organs
*KIDNEYS
Language
ISSN
0902-0063
Abstract
Introduction The outcome of ABO-incompatible kidney transplantation ( ABOi KT) has improved and is now comparable to that of ABO-compatible kidney transplantation ( ABOc KT). However, ABOi KT may be associated with a higher risk of postoperative bleeding than ABOc KT. Methods Seventy patients with ABOi KT were divided into a bleeding group (n = 9) and non-bleeding group (n = 61). General, immunologic, and hematological characteristics were compared to identify the risk factors for postoperative bleeding. Results Pre-emptive transplantation and a high pre-transplant blood urea nitrogen level were more common in the bleeding group (p = 0.0176 and 0.023, respectively). A high anti- ABO antibody titer after plasmapheresis (median, ≥16; p = 0.0226), a low platelet count of ≤100 000/mm3 after plasmapheresis (p = 0.0289), a prolonged activated partial thromboplastin time (p = 0.0073), and impaired platelet function (p = 0.0274) were associated with an increased risk of bleeding after ABOi KT. Conclusion Postoperative bleeding after ABOi KT was difficult to control and increased the risk of immediate graft loss (p = 0.015). Our results suggest that changes in coagulability associated with uremia and plasmapheresis may increase the risk of bleeding after ABOi KT. [ABSTRACT FROM AUTHOR]