[Peripheral thromboembolic complications in heart transplantation: prevalence and review of the literature].

Peripheral thrombotic complications were retrospectively analyzed in a series of 164 consecutive patients undergoing orthotopic cardiac transplantation (CT) at the University Clinic of Navarra from 1984 to 1999. The overall survival during the first year after CT was 82%. All patients, besides the immunosuppressive regimen, received antiplatelet treatment postoperatively. The prevalence of thrombotic complications was 18% (29 events in 25 patients): 21 (13%) corresponded to arterial thrombosis, mainly cerebrovascular, whereas 8 (5%) were venous thrombosis. The time between the CT and the onset of thrombosis was 2 +/- 1.8 years. Mortality in patients with thrombosis did not differ significantly from the global mortality. The analysis in relation to the presence of cardiovascular risk factors only showed statistical significant differences for the age (older in the group with thrombosis, p = 0.02). In conclusion, there is a high prevalence of peripheral thrombotic complications in patients undergoing CT despite the antithrombotic regimen administered. The lack of correlation with the traditional cardiovascular risk factors suggest additional mechanisms for thrombosis in these patients.