Shahnur Ahmed Dean Y. Kim Lauren E. Malinzak Ziad Al Adas Abigail Chatfield Timothy J Nypaver Mitchell R Weaver Alexander D. Shepard Loay S Kabbani
Wayne State University Henry Ford Health System
Introduction: There is limited information on the development and laterality of symptomatic deep vein thrombosis (DVT) following kidney transplantation. In this study, we want to define the incidence ..
Introduction: There is limited information on the development and laterality of symptomatic deep vein thrombosis (DVT) following kidney transplantation. In this study, we want to define the incidence of DVT in this population and determine if the side of DVT corresponds to the side of the transplanted kidney. Methods: We performed a retrospective review of all kidney transplant recipients from January, 2004 to August, 2014 at our institution and who subsequently developed symptomatic DVT. Kidney transplant recipients and confirmed DVT patients were obtained as two separate data files and were matched to obtain our cohort. Patients with concomitant pancreatic transplants, repeat, and bilateral kidney transplants were excluded. We used Cohen’s kappa statistic to test the agreement between the surgical incision site of the kidney transplant to the side at which the DVT occurred. Results: A total of 1827 kidney transplant recipients were performed between January 2004 to August 2014. A total of 877 kidney transplant recipients met the inclusion criteria as our total cohort. From our total cohort, 217 recipients underwent ultrasounds to rule out DVT. A total of 41 kidney transplant patients received a positive duplex ultrasound. The incidence of DVT in our kidney transplant cohort was 4.7%. The most common period of DVT diagnosis was in the perioperative period within the first 4 weeks. A Cohen kappa statistic of -0.02 occurred between the surgical incision site of the kidney transplant and the side of DVT occurrence. Large positive kappa statistic values indicate agreement, whereas large negative values indicate disagreement. Approximately 64.6% of transplant patients with a positive duplex ultrasound had a 1:1 correlation to the side of DVT, although this did not reach statistical significance. There was no statistically significant difference in patient sex, race, or age between the two groups. Conclusion: The incidence of symptomatic DVT in this cohort was 4.7%, which is lower than that reported in the literature. DVT was highest during the first four weeks postoperatively. There was an increased rate of ipsilateral DVTs to the kidney transplant, although this did not reach statistical significance.