García-Romero JL, Lerma-Sánchez V, Martínez-Ulloa-Torres J

Language: Spanish
References: 7
Page: 112-114
PDF size: 245.12 Kb.

ABSTRACT

Introduction: thrombotic disease is a well-known complication after renal transplantation. Some transplant recipients may have genetic coagulation abnormalities, such as hyperhomocysteinemia. The combined effects of kidney disease, folate deficiency, and vitamin B12 deficiency along with a common mutation (C677T) in the methylenetetrahydrofolate reductase (MTHFR) gene lead to elevated total plasma homocysteine ??in patients with end-stage chronic kidney disease; this generates a state of hypercoagulability that predisposes to thrombosis of the kidney transplant vein and early graft loss. Clinical case: a 15-year-old female patient with renal insufficiency of undetermined etiology, which had multiple thrombotic events and exhausted angioaccess. In her laboratories, factor V was found in 81%, antithrombin III in 88%, protein C in 78% , protein S 61%, lupus anticoagulant absent, anti-beta 2 glycoprotein IgM antibodies negative, all within normal parameters. However, given the high suspicion, it was decided to carry out a molecular genomic profile of 11 polymorphisms associated with thrombophilias. He was maintained on low molecular weight oral anticoagulants before, during, and after transplantation, along with folinic acid supplementation. So far with functional graft without evidence of graft thrombosis. Conclusion: genetic studies currently represent a useful tool, since they allow risk to be minimized by identifying mutations or polymorphisms that could increase morbidity and mortality after transplantation.

REFERENCES

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