Abstract
Background: End stage renal disease (ESRD) is associated with elevated fibrinogen levels and fibrinolysis inhibition. However, there is a paucity of data on how renal transplantation impacts coagulation. we hypothesize that renal transplantation recipients with good functioning grafts will have improved fibrinolytic activity following surgery. Methods: Kidney recipients were analyzed pre-operatively and on post-operative day 1(POD1) using three different TEG assays with and without two concentration of tissue-plasminogen activator (t-PA). TEG indices and percent reduction in creatinine from pre-op to POD1 were measured, with >50% defining “good” graft function. Follow up was done at 6, 12, and 24 months. Results: Percent lysis(LY30) on POD1 the t-PA TEG was significantly correlated to change creatinine from pre-op to POD-1(p = 0.006). A LY30 ≥ 23% was associated with good early graft function, and lower creatinine at 24-months(p = 0.028) compared to recipients with low POD1 LY30. Conclusions: Post-operative tPA-TEG LY30 is associated with favorable early and late outcomes in kidney transplant.
Original language | English (US) |
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Pages (from-to) | 1511-1517 |
Number of pages | 7 |
Journal | American Journal of Surgery |
Volume | 220 |
Issue number | 6 |
DOIs | |
State | Published - Dec 2020 |
Externally published | Yes |
Keywords
- Coagulation
- Fibrinolysis
- Kidney transplant
- TEG
- Thromboelastography
- t-PA
ASJC Scopus subject areas
- Surgery