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Incidence and outcome of isolated distal deep vein thrombosis in kidney transplant recipients

Annals of Surgical Treatment and Research 2020년 98권 6호 p.324 ~ 331
김미형 ( Kim Mi-Hyeong ) - Catholic University College of Medicine Eunpyeong St. Mary’s Hospital Department of Surgery

전강웅 ( Jun Kang-Woong ) - Catholic University College of Medicine Bucheon St. Mary’s Hospital Department of Surgery
황정기 ( Hwang Jeong-Kye ) - Catholic University College of Medicine Eunpyeong St. Mary’s Hospital Department of Surgery
박순철 ( Park Sun-Cheol ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Surgery
 ( Yun Sang-Seop ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Surgery
문인성 ( Moon In-Sung ) - Catholic University College of Medicine Yeouido St. Mary’s Hospital Department of Surgery
김지일 ( Kim Ji-Il ) - Catholic University College of Medicine Uijeongbu St. Mary’s Hospital Department of Surgery

Abstract


Purpose: Isolated distal deep vein thrombosis (IDDVT) is a localized lesion; nonetheless, the risk of proximal vein propagation makes it difficult to decide on the treatment protocol?that is, whether immediate anticoagulation after diagnosis or surveillance via serial imaging should be employed. This study aimed to investigate the appropriate treatment protocol for IDDVT in kidney transplant recipient (KTR).

Methods: Surveillance for venous thromboembolism (VTE) was performed using duplex ultrasonography (DUS) before transplant surgery and at 1 week, 2 weeks, 1 month, 3 months, 6 months, and 1 year after transplant surgery. Dual mechanical prophylaxis was administered to prevent VTE.

Results: In total, 60 out of 829 patients (7.2%) developed VTE, with 49 cases (81.6%) of IDDVT. Among IDDVT patients, 15 patients were treated using anticoagulation-first strategy, whereas the remaining 34 patients were treated using surveillance-first strategy. No patient in either group exhibited thrombus extension into the proximal vein or recurrence within 1 year from transplant surgery.

Conclusion: In Korean KTR, extension of IDDVT into the proximal vein could be prevented safely and effectively by serial DUS surveillance along with the maintenance of mechanical prophylaxis. However, the patients who have high thrombus burden or are difficult to get repeated DUS require the use of anticoagulation in early stages.

키워드

Anticoagulants; Kidney transplantation; Venous thrombosis
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