Changes in Thromboelastographic Findings after Renal Transplantation in Patients with Chronic Renal Failure / 대한마취과학회지

ABSTRACT

BACKGROUND: Recent studies of thromboelastograph (TEG) findings have revealed that the hemostatic process is enhanced in uremic patients, suggesting an increased risk of thrombosis formation. The pathogenesis of hypercoagulability appears to be multifactorial in origin, and to involve associated lipid metabolism abnormalities. The purpose of this study was to investigate changes in TEG findings and lipid metabolism after renal transplantation. METHODS: 23 patients scheduled for renal transplantation were included. PT, PT-INR, and aPTT were used as laboratory blood coagulation tests, and concentrations of triglyceride and total cholesterol as indices of lipid metabolism abnormalities. TEG variables were measured before renal transplantation, and again at one and three weeks after transplantation, and then compared with pre-transplantation values. RESULTS: The pre-transplantation values of alpha-angle, maximal amplitude and A60 were above the normal ranges, showing hypercoagulability. They reduced significantly after successful transplantation suggesting that the hypercoagulable tendency is relieved upon correcting uremia (P < 0.05). The lipid metabolism study showed hypertriglyceridemia before transplantation. Triglyceride concentrations reduced significantly to normal levels after renal transplantation (P < 0.05), and were correlated with changes in alpha-angle, maximal amplitude, A60, TEG index, and LY30 (P < 0.01). CONCLUSIONS: Patients with chronic renal failure, associated with hypertriglyceridemia, as a form of lipid metabolism abnormality, showed hypercoagulability on TEG. With the correction of uremia after renal transplantation, the hypercoagulable findings are relieved and triglyceride levels reduce to normal. The normalization of lipid metabolism after renal transplantation might have a participatory role in relieving hypercoagulability.