Management of antithrombotic therapies in kidney transplantation candidates and recipients: an ERBP clinical practice document by the DESCaRTES Working Group of ERA and the EKITA Committee of ESOT
ERBP · 2026 · Europe
Source and licence
- Authors
- Arzu Velioglu, Artemios G Karagiannidis, Erol Demir et al.
- Title
- Management of antithrombotic therapies in kidney transplantation candidates and recipients: an ERBP clinical practice document by the DESCaRTES Working Group of ERA and the EKITA Committee of ESOT
- Journal
- Nephrology Dialysis Transplantation, 2026
- Licence
- CC BY 4.0
- Changes
- Verbatim excerpts; formatting adapted
Full text retrieved 2026-10-27 from Europe PMC · PMC13518092
Licence statement of the original publication
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Open the original publication →Full text on Europe PMC
Recommendations
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Abstract
Thromboembolic and atherosclerotic disorders, necessitating antithrombotic therapies, are prevalent among patients with advanced chronic kidney disease (CKD), as well as in kidney transplant (KT) recipients. However, the optimal management of antithrombotic therapies in these patients remains uncertain due to conflicting evidence and the exclusion of advanced CKD and KT recipients from major randomized controlled trials. Additionally, the perioperative management of antithrombotic therapy in end-stage kidney disease patients undergoing transplantation requires specific attention. This clinical practice document prepared by experts from the DESCaRTES Working Group of the European Renal Association (ERA) and European Kidney Transplant Association (EKITA) from European Society of Organ Transplantation (ESOT) following European Renal Best Practice (ERBP) guidelines is designed to support clinicians in decision making on antithrombotic therapies in KT candidates and recipients. Following a detailed systematic literature review, it presents current knowledge in epidemiology and pathophysiology and summarizes all relevant studies in this topic.
Contents of the original publication
The section headings of the original.
- INTRODUCTION
- PATHOPHYSIOLOGY OF BLEEDING AND THROMBOSIS IN ESKD
- Bleeding risk
- Thrombosis risk
- Effect of kidney replacement therapies on hemostasis
- PATHOPHYSIOLOGY OF BLEEDING AND THROMBOSIS DURING KIDNEY TRANSPLANTION SURGERY
- PATHOPHYSIOLOGY OF BLEEDING AND THROMBOSIS IN KT RECIPIENTS
- ANTITHROMBOTIC THERAPIES
- Antiplatelet agents
- Anticoagulant agents
- SCORES FOR ASSESSING BLEEDING AND THROMBOTIC RISK
- METHODOLOGY—SYSTEMATIC SEARCH
- QUESTION 1: WHAT IS THE PERI-OPERATIVE BLEEDING RISK IN KT CANDIDATES WHO ARE ON ANTIPLATELET OR ANTICOAGULANT DRUGS?
- Background and rationale
- Summary of evidence
- Translation of the evidence into clinical practice
- What do existing guidelines say?
- Clinical practice points
- QUESTION 2: SHOULD KT RECIPIENTS RECEIVE PROPHYLAXIS FOR VENOUS THROMBOSIS AFTER SURGERY?
- Background and rationale
- Summary of evidence
- Translation of the evidence into clinical practice
- What do existing guidelines say?
- Clinical practice points
- QUESTION 3: CAN WE USE DOACs IN KT RECIPIENTS IN TERMS OF SAFETY (DOSING, DRUG–DRUG INTERACTIONS, ADVERSE EVENTS)?
- Background and rationale
- Summary of evidence
- Translation of the evidence into clinical practice
- What do existing guidelines say?
- Clinical practice points
- QUESTION 4: IS THERE A NEED FOR INTERRUPTION OF ANTIPLATELET THERAPY BEFORE GRAFT BIOPSY?
- Background and rationale
- Summary of evidence
- Translation of the evidence into clinical practice
- What do existing guidelines say?
- Clinical practice points
- LIMITATIONS OF INCLUDED STUDIES
- SUGGESTIONS FOR FUTURE RESEARCH
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