Frequency, potential risk and therapeutic intervention in end-stage renal disease patients with antiphospholipid antibody syndrome

A multicenter study

Smita Vaidya, Rachel Sellers, Pamela Kimball, Thomas Shanahan, Jermy Gitomer, Kristene Gugliuzza, Jay C. Fish

Research output: Contribution to journalArticle

79 Citations (Scopus)

Abstract

Background. Antiphospholipid antibody syndrome (APAS) is characterized by the presence of anticardiolipin antibodies (ACA) in association with thrombotic disorders of arterial and/or venus systems, spontaneous abortion(s) or thrombocytopenia. Methods. In this multicenter study, 502 end- stage renal disease (ESRD) patients awaiting renal transplants were screened to determine the frequency of APAS, the potential risk associated with APAS, and strategies for therapeutic intervention. Ninety-three patients (19%) had high titers of ACA. Twenty-three patients had documented evidence of one or more of the thrombotic disorders such as lupus, frequent abortions, frequent thrombosis of arteriovenous shunts, biopsy-proven microrenal angiopathy, or thrombocytopenia and thus were diagnosed with APAS. Of these 23 patients, 11 received kidney transplants either with (4 patients) or without (7 patients), concomitant anticoagulation therapy. Results. All seven of the patients with APAS not treated with anticoagulation therapy lost their allografts within 1 week as a result of renal thrombosis. In contrast, three out of four transplant patients with APAS treated with anticoagulation therapy maintained their allografts for over 2 years. The fourth patient lost his graft within a week because of thrombosis. Of the remaining 70 patients with high titers of ACA but no evidence of thrombotic disorders, 37 received kidney transplants. None lost their allografts as a result of thrombosis. Our data suggest that, although 19% of our ESRD patients exhibit high titer of ACA, only 5% of the patients have APAS. Conclusion. In conclusion, our data suggest that the patients with APAS are at high risk of posttransplant renal thrombosis. Anticoagulation therapy could prevent patients from posttransplant thrombosis in patients with APAS.

Original languageEnglish (US)
Pages (from-to)1348-1352
Number of pages5
JournalTransplantation
Volume69
Issue number7
StatePublished - Apr 15 2000

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Antiphospholipid Syndrome
Multicenter Studies
Chronic Kidney Failure
Anticardiolipin Antibodies
Thrombosis
Therapeutics
Transplants
Kidney
Allografts
Thrombocytopenia
Venus
Spontaneous Abortion

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Frequency, potential risk and therapeutic intervention in end-stage renal disease patients with antiphospholipid antibody syndrome : A multicenter study. / Vaidya, Smita; Sellers, Rachel; Kimball, Pamela; Shanahan, Thomas; Gitomer, Jermy; Gugliuzza, Kristene; Fish, Jay C.

In: Transplantation, Vol. 69, No. 7, 15.04.2000, p. 1348-1352.

Research output: Contribution to journalArticle

Vaidya, Smita ; Sellers, Rachel ; Kimball, Pamela ; Shanahan, Thomas ; Gitomer, Jermy ; Gugliuzza, Kristene ; Fish, Jay C. / Frequency, potential risk and therapeutic intervention in end-stage renal disease patients with antiphospholipid antibody syndrome : A multicenter study. In: Transplantation. 2000 ; Vol. 69, No. 7. pp. 1348-1352.
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