Prophylaxis of Pulmonary Embolism in Kidney Transplant Recipients.

Abstract

Kidney transplant recipients have an increased risk of pulmonary embolism; however, thromboprophylaxis poses a challenge as the risk of thrombosis must be balanced against the risk of bleeding. This review summarizes the evidence on whether thromboprophylaxis is required in kidney transplantation. Incidence of venous thromboembolism, comprising pulmonary embolism and deep venous thrombosis, is increased in kidney transplant recipients compared to the general population, with augmented risk of death and graft loss. Findings suggest a benefit of prophylaxis with heparin and mechanical prophylaxis for low-risk patients. For patients at high risk, with previous thrombosis, and/or abnormal thrombophilia screen, dose and prophylaxis time need to be increased. There is no established thromboprophylaxis strategy. It is crucial to evaluate patient's risk profile and opt for a multidisciplinary approach for the development of appropriate prophylaxis. There remains a paucity of high-quality evidence for effective prophylaxis strategies in this population.