MP61-19 PREOPERATIVE USE OF ANTIPLATELETS AND ANTICOAGULANTS IN DECEASED DONOR RENAL TRANSPLANTS DOES NOT RESULT IN INCREASED COMPLICATION RATES

You have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation & Vascular Surgery I1 Apr 2018MP61-19 PREOPERATIVE USE OF ANTIPLATELETS AND ANTICOAGULANTS IN DECEASED DONOR RENAL TRANSPLANTS DOES NOT RESULT IN INCREASED COMPLICATION RATES William Berg, Edward Forsyth, Chris Du, Charles Loeb, Anjali Kapur, Kailash Kapadia, Alice Cheung, Yu Wang, and Frank Darras William BergWilliam Berg More articles by this author , Edward ForsythEdward Forsyth More articles by this author , Chris DuChris Du More articles by this author , Charles LoebCharles Loeb More articles by this author , Anjali KapurAnjali Kapur More articles by this author , Kailash KapadiaKailash Kapadia More articles by this author , Alice CheungAlice Cheung More articles by this author , Yu WangYu Wang More articles by this author , and Frank DarrasFrank Darras More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1998AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Deceased donor renal transplants (DDRT) offer unique challenges to the perioperative management of antiplatelet agents (AP) and anticoagulants (AC). Patients present for surgery without the ability to hold AP or AC in the preoperative period. We sought to analyze the outcomes of patients undergoing deceased donor renal transplant (DDRT) who were actively taking AP and AC in the preoperative period. METHODS Our renal transplant database was queried for patients who underwent a DDRT. Patients were excluded if they underwent a living donor renal transplant. Patients were then divided into three groups, those taking AP, AC, or neither. Demographic, clinical, operative, and postoperative variables were then compared. Our main outcome variable was reoperation rate. RESULTS 654 patients were identified, of which 149 were taking AP and 36 were taking AC. Significant differences between groups were observed for age, race, smoking status, diabetes, coronary artery disease, history of myocardial infarction, and history of atrial fibrillation (all p<0.01). Furthermore, a significant difference was seen in the rate of transfusion of packed RBCs intraoperatively and on postoperative day 0 (p<0.01). There was a trend towards significance between groups for average estimated blood loss (p=0.05). No significant differences were found for reoperation rates for bleeding, hospital length of stay, need for postoperative dialysis, or Clavien-Dindo complication grade. In a multivariate logistic regression model using both stepwise selection and a forced covariate model, no demographic, clinical, or operative variables significantly predicted reoperation rate. CONCLUSIONS To our knowledge, this is the largest study to date regarding the effect of AP and AC on the DDRT population. Perioperative transfusion rate was the only significant outcome variable. In our cohort, there does not appear to be a significant difference in overall outcomes for patients on AP or AC. This data will help inform preoperative counseling and postoperative expectations. While this is the largest series to date, future research with larger sample sizes is needed to explore the effects of preoperative AP and AC on complications risks and long-term graft survival. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e830-e831 Advertisement Copyright & Permissions© 2018MetricsAuthor Information William Berg More articles by this author Edward Forsyth More articles by this author Chris Du More articles by this author Charles Loeb More articles by this author Anjali Kapur More articles by this author Kailash Kapadia More articles by this author Alice Cheung More articles by this author Yu Wang More articles by this author Frank Darras More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...