Impact of acetylsalicylic acid on perioperative bleeding complications in deceased donor kidney transplantation

• DOI: 10.1007/s00345-024-05426-y
• Publication Date: 2025-01-03T09:43:42Z
• Authors: Frank Friedersdorff; Matthias Schulz; Sarah Weinberger; Scarlet Munayco R...; Bernhard Ralla; Lutz Liefeldt; Martin Kanne; Senem Sakar; Markus H. Lerchba...; Thorsten Schlomm; Isabel Lichy; Robert Peters; Jacob Schmidt

Abstract Purpose The objective of this study was to evaluate the perioperative outcomes and complications associated with the use of acetylsalicylic acid (ASA) in deceased donor kidney transplantation (KTX), with a particular focus on bleeding events.

Methods We retrospectively analyzed 157 kidney transplant recipients (KTRs) who underwent KTX at Charité Berlin, Department for Urology, between February 2014 and December 2017. Patients were divided into two groups: patients with ASA in their preoperative medication (Group A, n = 59) and patients without ASA use (Group B, n = 98). Data on demographic information, medical conditions, surgical details, and postoperative outcomes were analyzed. Complications were classified using the Clavien-Dindo classification. Statistical analyses included t-tests, chi-square tests, and multivariate logistic regression.

Results Group A had significantly older donors (59.7 ± 12.9 years vs. 52.0 ± 14.1 years, p < 0.001) and a higher incidence of coronary artery disease (42.4% vs. 3.1%, p = 0.001). There were no significant differences in perioperative hemoglobin loss and perioperative bleeding events between the groups, but a tendency towards higher rates of intraoperative bleeding (15.3% vs. 8.2%, p = 0.17) and postoperative transfusions (22% vs. 13.3%, p = 0.15) in Group A. Mortality was higher in Group A (18.6% vs. 4.1%, p = 0.003), with one death attributed to a cardiac event. Kaplan-Meier analysis revealed significantly inferior overall survival for Group A (p = 0.02), but no significant difference in graft survival (p = 0.18).

Conclusion ASA use is associated with a trend towards increased intraoperative bleeding and postoperative blood transfusion but does not significantly increase major postoperative bleeding complications. Careful perioperative monitoring of patients with ASA is recommended.