Kazory Amir, Ducloux Didier
Department of Nephrology and Renal Transplantation, Saint-Jacques University Hospital, 25000, Besançon, France.
Thromb Haemost. 2004 Apr;91(4):646-54. doi: 10.1160/TH03-09-0568.
Stable renal transplant recipients manifest a chronic hypercoagulable state with an increased risk of thromboembolic complications, which appears to be multifactorial. While this group of patients could present the known risk factors for thromboembolism in the general population (e.g. diabetes, cancer, pregnancy), they may also suffer from other situations which are mostly related to transplantation and are consequently specific to them. Here, we review briefly the clinical aspects and controversies of the most important of these factors including immunosuppressive agents, antiphospholipid antibodies, hyper-homocysteinemia, pre-transplant dialysis modality, and post-transplant erythrocytosis. In addition, other more recent topics including hypercysteinemia, recurrent proteinuria, and acute CMV infection are discussed.
稳定的肾移植受者表现出慢性高凝状态，血栓栓塞并发症风险增加，这似乎是多因素导致的。虽然这组患者可能存在普通人群中已知的血栓栓塞风险因素（如糖尿病、癌症、妊娠），但他们也可能遭受其他大多与移植相关且因此具有特异性的情况。在此，我们简要回顾这些最重要因素的临床方面及争议，包括免疫抑制剂、抗磷脂抗体、高同型半胱氨酸血症、移植前透析方式和移植后红细胞增多症。此外，还讨论了其他一些较新的话题，包括高半胱氨酸血症、复发性蛋白尿和急性巨细胞病毒感染。
