Blood Coagulation, Fibrinolytic and Inhibitory Profiles in Renal Transplant Recipients: Comparison of Cyclosporine and Azathioprine

Renal transplant recipients treated with cyclosporine (CS) have been reported to be at increased risk of thrombotic complications. The present study was intended to examine the blood coagulation, fibrinolytic, and inhibitory systems in such patients. Eight transplant recipients on maintenance immunosuppression with CS and prednisone were studied. Five transplant recipients maintained on azathioprine (AZA) and prednisone and 32 normal volunteers served as controls. Plasma antigen concentrations and/or activities of various proteins in the above pathways were measured. Both the CS and AZA groups exhibited significant elevations of factor IX activity, von Willebrand factor (vWF), D-dimer, protein C and tissue type plasminogen activator (t-PA) levels when compared with the normal controls. In addition, CS group showed a significant elevation of α2-macroglobulin activity and AZA group showed a significant reduction in factor XII activity when compared with the normal controls. Comparison of data from CS and AZA groups revealed higher factor XII activity and vWF concentration in the former group. In conclusion, transplant recipients treated with long-term cyclosporine and prednisone exhibited significant elevation of plasma vWF, D-dimer and protein C concentrations. In addition, both CS and AZA-treated transplant recipients showed increased plasma concentrations of D-dimer and t-PA. The latter observations suggest in vivo thrombin generation, fibrin formation and degradation.

[1]  B. Chavers,et al.  ALLOGRAFT RENAL VASCULAR THROMBOSIS‐LACK OF INCREASE WITH CYCLOSPORINE IMMUNOSUPPRESSION , 1989, Transplantation.

[2]  M. Dunnill,et al.  Renal vascular thrombosis of cadaveric renal allografts in patients receiving cyclosporin, azathioprine and prednisolone triple therapy , 1988 .

[3]  A. Grace,et al.  Cyclosporine A enhances platelet aggregation. , 1987, Kidney international.

[4]  G. Allaire,et al.  Hemolytic uremic syndrome in renal allografted patients treated with cyclosporin. , 1987, Canadian journal of physiology and pharmacology.

[5]  P. Rigotti,et al.  Increased incidence of renal allograft thrombosis under cyclosporine immunosuppression. , 1986, International surgery.

[6]  M. Goldman,et al.  Increase in urinary thromboxane B2 in rats caused by cyclosporine. , 1985, Transplantation.

[7]  T. Lerut,et al.  THROMBOEMBOLIC COMPLICATIONS AND HAEMOSTATIC CHANGES IN CYCLOSPORIN-TREATED CADAVERIC KIDNEY ALLOGRAFT RECIPIENTS , 1985, The Lancet.

[8]  R. Merion,et al.  Allograft renal vein thrombosis. , 1985, Transplantation proceedings.

[9]  G. Neild,et al.  Glomerular thrombi in renal allografts associated with cyclosporin treatment. , 1985, Journal of clinical pathology.

[10]  G. Remuzzi,et al.  EFFECT OF CYCLOSPORINE ON PROSTACYCLIN SYNTHESIS BY VASCULAR TISSUE IN RABBITS , 1983 .

[11]  G. Neild,et al.  GLOMERULAR THROMBI AND INFARCTION IN RABBITS WITH SERUM SICKNESS FOLLOWING CYCLOSPORINE THERAPY , 1983 .

[12]  D. Cannarozzi,et al.  An improved turbidimetric method for plasma fibrinogen. , 1977, The American journal of medical technology.

[13]  R. R. Proctor,et al.  The partial thromboplastin time with kaolin. A simple screening test for first stage plasma clotting factor deficiencies. , 1961, American journal of clinical pathology.

[14]  A. Quick.  ON THE CONSTITUTION OF PROTHROMBIN , 1943 .