INCREASED RENAL-ALLOGRAFT THROMBOSIS IN CAPD PATIENTS

In a retrospective analysis of 202 renal transplant procedures in the years 1989-1992 we identified an excess of grafts lost from primary re novascular thrombosis in patients receiving continuous ambulatory peri toneal dialysis (CAPD) compared to haemodialysis (HD) patients (9 CAPD versus 0 HD, Chi-squared = 9.63; P<0.01). All graft losses from throm bosis occurred within 16 days of surgery. Possible predisposing causes were identified in three patients. Donor age was greater in CAPD pati ents losing their kidneys from thrombosis compared to the overall CAPD group [mean (SD) years, 43.0(12.9) versus 29.1(15.8); P = 0.01] where as no significant difference in haematocrit, platelet count, antibody status, cyclosporin use, perioperative hypotension, primary diagnosis, smoking, or diabetes mellitus was found. Data from the EDTA registry for 1990-91 show that graft loss from primary renovascular thrombosis in UK-treated patients was reported in 7.1% of CAPD recipients compare d with 1.8% in haemodialysis. We suggest that CAPD patients are at gre ater risk of graft loss from renovascular thrombosis than HD patients and may require more intensive fluid and anticoagulant treatment in th e perioperative period.