RISK FACTORS FOR VASCULAR THROMBOSIS IN PEDIATRIC RENAL TRANSPLANTATION

Vascular thrombosis is one of the more difficult problems of pediatric renal transplantation; its etiology in multifactorial and, in most cases, it is irreversible. Vascular thrombosis accounts for 12.9% of graft failures in primary transplants in children and for 20% of graft failures in repeat transplants. Although it is seen most often in very young recipients and in recipients of kidneys from young donors, it can manifest in older children and adolescents as well. The peak incidence is seen in the first 48 h after transplantation; however, the event may be delayed until after the first week. When thrombosis occurs in an adolescent patients late in the course of transplantation, the pathogenesis is undetermined and immunosuppressive therapy is frequently implicated. This article describes a 19-yr-old patient with a three-antigen-matched cadaveric kidney who received cyclosporine and anti-thymocyte globulin for induction. Vascular thrombosis occurred after 7 d of initial good function. Eventually the graft was removed after attempts to re-establish vascularization failed. The patient received a second graft and despite an optimal six-antigen-match and different immunosuppression with tacrolimus, thrombosis recurred by the fifth postoperative day. The discussion that follows reviews the incidence and the factors implicated in the pathogenesis of this entity.

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SURVEY OF CARDIOVASCULAR RISK FACTORS AND ELECTROCARDIGRAPHIC, ECHOCARDIOGRAPHIC ABNORMALITIES IN PATIENTS ON WAITING LIST FOR RENAL TRANSPLANTATION

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2014.1.4 ◽

2014 ◽

pp. 26-30

Author(s):

Huu Thinh Nguyen ◽

Thi Thuy Hang Nguyen ◽

Bui Bao Hoang

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Renal Transplantation ◽

Left Ventricular Hypertrophy ◽

Cardiovascular Risk Factors ◽

Ventricular Hypertrophy ◽

Left Ventricular ◽

Valve Insufficiency ◽

Transplant Candidates ◽

End Stage

Background: Cardiovascular disease is the major cause of death in dialysis patients, as well as in kidney transplant patients. Assessment of cardiovascular risks of renal transplant candidates to prevent or slow the progression of cardiovascular abệnh nhânormalities. Aim: 1) Evaluating cardiovascular risk factors, electrocardiographic and echocardiographic abnormalities in renal transplant candidates. 2) Identifying the correlation between cardiac morphological parameters with a number of factors involved. Subjects and Methods: We assessed 57 patients (73.7% male, mean age 32.4±8.8) with end-stage renal disease waiting for renal transplantation at Cho Ray Hospital between Jan 2012 and Jan 2013. All patients received a physical examination, blood pressure measurement, Hb, blood glucose test, lipid profile, ECG, echocardiography. Results: The percentage of hypertension was 98.2%, smoking (69.2%), dyslipidemia 40.4% and diabetes 12.3%. All patients had sinus rhythm, left ventricular hypertrophy 61.4% in ECG. Pericardial effusion 5.3%, mitral valve insufficiency 56.1%, aortic valve insufficiency 12.3%, left ventricular hypertrophy 94.7% in echocardiography. IVSd, LVPWd, LVMI positively correlated with kidney failure time (p <0.01, p<0.001), with DBP and SBP (p <0.05) and the degree of anemia (p <0.05). Percentage the degree of hypertension associated with proportion of left ventricular hypertrophy (p <0.05). Conclusions: Identification of cardiovascular risk factors for the prevention or intervention to reduce mortality in renal transplantation. Keywords: Cardiovascular risk factors, end-stage chronic renal failure, renal transplantation.

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