Clopidogrel use as a risk factor for poor outcomes after kidney transplantation. Am J Surg 2014 Oct;208(4):556-62
Date
09/23/2014Pubmed ID
25241952DOI
10.1016/j.amjsurg.2014.06.007Scopus ID
2-s2.0-84908126549 (requires institutional sign-in at Scopus site) 6 CitationsAbstract
BACKGROUND: Limited data are available on outcome implications of clopidogrel use before kidney transplantation.
METHODS: A novel dataset linking national transplant registry data with records from a large pharmacy claims clearinghouse (2005 to 2010) was examined to estimate risks of post-transplant death and graft failure associated with clopidogrel fills within 90 or more than 90 days before transplant.
RESULTS: Clopidogrel fills within 90 days of transplant were associated with 61% of increased relative mortality risk and 23% of increased graft failure risk. Risks were higher in those whose last clopidogrel fill was more than 90 days before transplantation (111% for death, 59% for graft loss). Adverse prognostic associations persisted among recipients of live and deceased donor allografts, older recipients, and those with diabetes or reported cardiovascular disease.
CONCLUSIONS: Clopidogrel use before kidney transplantation portends increased risks of post-transplant death and graft loss. Pharmacy claims may identify novel prognostic markers not currently captured in the transplant registry.
Author List
Williams JM, Tuttle-Newhall JE, Schnitzler M, Dzebisashvili N, Xiao H, Axelrod D, Mogal H, Lentine KLMESH terms used to index this publication - Major topics in bold
Cardiovascular DiseasesDose-Response Relationship, Drug
Female
Follow-Up Studies
Graft Rejection
Graft Survival
Humans
Kidney Failure, Chronic
Kidney Transplantation
Male
Middle Aged
Platelet Aggregation Inhibitors
Postoperative Period
Prognosis
Registries
Retrospective Studies
Risk Assessment
Risk Factors
Survival Rate
Ticlopidine
Tissue Donors
Transplantation, Homologous
United States
