Hemorrhagic Complications of Enoxaparin and Aspirin in Patients with Kidney Transplants

Study Objective. To evaluate the frequency of early posttransplant hemorrhagic complications in patients with kidney and kidney‐pancreas transplants who received thromboprophylaxis with enoxaparin and aspirin. Design. Retrospective chart review. Setting. University‐based tertiary care center. Patients. Thirteen patients who had received enoxaparin within 10 days of kidney or kidney‐pancreas transplantation. Intervention. Medical records were reviewed, and data from patients who had received low‐dose aspirin 81 mg once/day and enoxaparin within 10 days of transplantation were collected. Measurements and Main Results. Major bleeding events were defined as intracranial or retroperitoneal bleeding, or a decrease in hemoglobin of greater than 2 g/dl that was confirmed on repeat evaluation. Nine (69%) of the 13 patients had confirmed major bleeding events and required blood transfusions. Six of the nine patients had elevated serum creatinine levels. Conclusion. The combination of enoxaparin and low‐dose aspirin early after kidney or kidney‐pancreas transplantation was associated with a high frequency of hemorrhagic events. Further evaluation is needed to determine the safety of enoxaparin in combination with aspirin after transplantation.