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Efficacy and safety of non-vitamin K antagonist oral anticoagulants post-kidney transplantation

World Journal of Transplantation 2019年第6期9卷 134-144页

作者： Muhammad A Bukhari Abdulrahman Al-Theaby Mohammed Tawhari Ali Al-Shaggag ryan pyrke Azim Gangji Darin Treleaven Christine Ribic Department of Medicine Taif UniversityTaif 26311Saudi Arabia Department of Transplantation King Abdulaziz Medical CityRiyadh 11159Saudi Arabia Department of Nephrology and Transplantation King Fahad Specialist Hospital Dammam 15215Saudi Arabia Department of Nephrology McMaster UniversityHamiltonON L8N 4A6Canada

BACKGROUND Novel oral anticoagulants(NOACs)were developed as alternatives to vitamin K antagonists,primarily warfarin,as they do not require routine monitoring and have limited drug-drug and drug-food ***,the efficacy and safety of these agents in kidney transplantation are not well *** To assess the profile and safety of NOACs for patients who had kidney transplantation,and to provide recommendations and guidelines on therapeutic strategies in these *** This was a retrospective study carried out among adult patients who were actively on the following NOACs(apixaban,rivaroxaban or dabigatran)in our renal transplantation program from December 2015 to December *** patients were identified primarily through electronic medical record system(patient data linkage).Data on the clinical and laboratory profile of the patients were retrieved and analyzed with SPSS *** Complete data on 42 renal transplant patients were retrieved:59.5%males,90.5%were whites and 66.7%were older than 60 years *** mean duration since renal transplantation of the patients was 8.8±7.4 *** most common risk factors for the development of end-stage renal disease in the subjects were hypertension(19.0%),polycystic kidney disease(19.0%),followed by diabetic nephropathy(16.7%)and chronic glomerulonephritis(16.7%).The main indications for NOACs use in the cohort were atrial fibrillation in 25 patients(59.5%)and venous thromboembolism in 10 patients(23.8%).Overall,29 patients(69%)were treated with apixaban,10 patients(23.8%)with rivaroxaban and 3 patients(7.14%)with ***(0%)thromboembolic events were observed during the one-year period,but 3(7.1%)bleeding events occurred in the cohort consisting of 1 patient treated with rivaroxaban 15 mg daily and 2 patients who received apixaban 2.5 mg twice *** were no significant changes in serum tacrolimus level three days after the initiation of NOACs among patients treated with tacrolimus(

关键词： Novel oral anticoagulants Adult patients Kidney transplantation Renal outcomes Efficacy

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