Robertson A J, Nargund V, Gray D W, Morris P J
Nuffield Department of Surgery, Oxford Transplant Centre, Churchill Hospital, Headington, Oxford, UK.
Nephrol Dial Transplant. 2000 Nov;15(11):1865-8. doi: 10.1093/ndt/15.11.1865.
Renal-vein thrombosis (RVT) is an infrequent event that accounts for a high proportion of early renal allograft losses, since graft failure secondary to acute irreversible rejection is now relatively rare. The cause of RVT may be related to technical problems, clotting disorders, diabetes, or cyclosporin, but is often difficult to define.
This retrospective study was performed to examine the influence of aspirin on the incidence of RVT in cadaveric and living-related renal transplant recipients receiving cyclosporin-based triple immunosuppression. The Oxford Transplant Centre database was used to identify all early (<30 day) non-immunological graft failures and case histories were examined for clinical and pathological evidence of RVT. In July 1991, aspirin (75 mg o.d. starting immediately before and continuing for 1 month post-transplant) was introduced as routine prophylaxis against RVT. Prior to this, aspirin prophylaxis was not used.
In the 6-year period from July 1985 to June 1991, there were 27 cases of RVT in 475 transplants (5.6%). In the subsequent 6-year period, there were six cases of RVT in 480 transplants (1.2%) (P:<0.01).
Although not abolished, this indicates a significant reduction in the incidence of RVT with the addition of low-dose aspirin.
肾静脉血栓形成(RVT)是一种不常见的事件,但在早期肾移植失败中占很大比例,因为继发于急性不可逆排斥反应的移植失败现在相对少见。RVT的病因可能与技术问题、凝血障碍、糖尿病或环孢素有关,但往往难以明确。
本回顾性研究旨在探讨阿司匹林对接受以环孢素为基础的三联免疫抑制治疗的尸体供肾和亲属活体供肾移植受者RVT发生率的影响。利用牛津移植中心数据库确定所有早期(<30天)非免疫性移植失败病例,并检查病历以寻找RVT的临床和病理证据。1991年7月,开始常规使用阿司匹林(移植前立即开始,每天75毫克,持续至移植后1个月)预防RVT。在此之前,未使用阿司匹林进行预防。
在1985年7月至1991年6月的6年期间,475例移植中有27例发生RVT(5.6%)。在随后的6年期间,480例移植中有6例发生RVT(1.2%)(P<0.01)。
虽然未完全消除,但这表明加用小剂量阿司匹林后RVT的发生率显著降低。