Clopidogrel use as a risk factor for poor outcomes after kidney transplantation - 22/09/14
, Mark Schnitzler, Ph.D. a, b, Nino Dzebisashvili, Ph.D. c, Huiling Xiao, M.S. a, b, David Axelrod, M.D., M.B.A. c, Harveshp Mogal, M.D. a, Krista L. Lentine, M.D., Ph.D. a, b, dAbstract |
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.
Le texte complet de cet article est disponible en PDF.Keywords : Clopidogrel, Death, Graft loss, Kidney transplantation, Outcomes, Pharmacy records
Plan
| The authors declare no conflicts of interest. |
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| Data reported here have been supplied by the United Network for Organ Sharing (UNOS) as the contractor for the Organ Procurement and Transplantation Network (OPTN). The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy of or interpretation by the OPTN, the US Government, the NIDDK, or the National Institutes of Health. |
Vol 208 - N° 4
P. 556-562 - octobre 2014 Retour au numéro
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