Outcomes of Kidney Transplant Recipients on Dual Antiplatelet Therapy

Background: Kidney Transplant (KTX) recipients often have co morbidities requiring anti-platelet therapy with 1 or 2 agents. Whereas a few reports have examined outcomes with one agent, none have evaluated outcomes of KTX recipients on dual antiplatelet agents. Methods: Consecutive adult kidney-only recipients from 10/11-9/14 taking aspirin alone (ASA, n=135), ASA and Plavix® (DUAL, n=23), or no Antiplatelet therapy (NONE, n=209) at the time of transplantation were assessed for several outcomes post-transplantation. Results: Of 367 patients, the overall incidence of blood transfusion within 5 days of KTX was 34.6%. Compared to the NONE group, DUAL or ASA alone, were associated with perioperative blood transfusion (27.8%, 52.2%, 42.2%, p<0.01), but not reoperation for bleeding (1.0%, 0.0%, 1.5% p=0.79), delayed graft function (47.9%, 52.2%, 51.1% p=0.81), length of stay > 6 days (31.1%, 34.8%, 36.3% p=0.60), 30-day readmission (26.8%, 21.7%, 33.6% p=0.30), or overall graft failure (7.7%, 4.4%, 7.4% p=0.85), respectively. Despite univariate association, blood transfusion was not significantly associated with ASA (aOR: 1.42, CI: 0.86-2.34), or DUAL (aOR: 1.87, CI: 0.75-4.66) on multivariate analysis. Conclusion: KTX with single or dual antiplatelet therapy may not carry an increased risk of blood transfusion or other adverse outcomes after other risk factors are accounted for.