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Direct Oral Anticoagulation in Lung Transplant Recipients


Hage, René; Bonzon, Jerome; Schuurmans, Macé M (2024). Direct Oral Anticoagulation in Lung Transplant Recipients. Experimental and Clinical Transplantation, 22(4):249-257.

Abstract

Objectives: Presently, the management of direct oral anticoagulants lacks specific guidelines for patients before and after transplant, particularly for lung transplant recipients. We aimed to consolidate the existing literature on direct oral anticoagulants and explore their implications in lung transplant recipients.
Materials and Methods: We conducted a comprehen-sive search in PubMed and Google Scholar databases for studies published between January 2000 and December 2022, using specific search terms. We only included studies involving lung transplant recipients and focusing on direct oral anticoagulants.
Results: Five relevant publications were identified, providing varied insights. None of the studies specifically addressed bleeding complications associ-ated with direct oral anticoagulants in lung transplant recipients. Limited details were available on the type of solid-organ transplant or the specific direct oral anticoagulant used in these studies.
Conclusions: Varied bleeding complications associated with direct oral anticoagulants in lung transplant recipients were reported, but studies lacked specificity on transplant type and direct oral anticoagulant variations. Notably, the incidence of venous throm-botic embolism in lung transplant recipients was comparatively higher than in other solid-organ transplant recipients, potentially linked to factors such as corticosteroid therapy, calcineurin inhibitors, and cytomegalovirus infections. Our synthesis on findings of use of direct oral anticoagulant in lung transplant recipients emphasized challenges of managing these medications in urgent transplant situations. Recom-mendations from experts suggested caution in initiation of direct oral anticoagulants posttransplant until stability in renal and hepatic function is achieved. The limited evidence on safety of direct oral anti-coagulants in lung transplant recipients underscores the need for further research and guidance in this specific patient population.

Abstract

Objectives: Presently, the management of direct oral anticoagulants lacks specific guidelines for patients before and after transplant, particularly for lung transplant recipients. We aimed to consolidate the existing literature on direct oral anticoagulants and explore their implications in lung transplant recipients.
Materials and Methods: We conducted a comprehen-sive search in PubMed and Google Scholar databases for studies published between January 2000 and December 2022, using specific search terms. We only included studies involving lung transplant recipients and focusing on direct oral anticoagulants.
Results: Five relevant publications were identified, providing varied insights. None of the studies specifically addressed bleeding complications associ-ated with direct oral anticoagulants in lung transplant recipients. Limited details were available on the type of solid-organ transplant or the specific direct oral anticoagulant used in these studies.
Conclusions: Varied bleeding complications associated with direct oral anticoagulants in lung transplant recipients were reported, but studies lacked specificity on transplant type and direct oral anticoagulant variations. Notably, the incidence of venous throm-botic embolism in lung transplant recipients was comparatively higher than in other solid-organ transplant recipients, potentially linked to factors such as corticosteroid therapy, calcineurin inhibitors, and cytomegalovirus infections. Our synthesis on findings of use of direct oral anticoagulant in lung transplant recipients emphasized challenges of managing these medications in urgent transplant situations. Recom-mendations from experts suggested caution in initiation of direct oral anticoagulants posttransplant until stability in renal and hepatic function is achieved. The limited evidence on safety of direct oral anti-coagulants in lung transplant recipients underscores the need for further research and guidance in this specific patient population.

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Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Clinical Pharmacology and Toxicology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:April 2024
Deposited On:13 May 2024 14:46
Last Modified:16 May 2024 08:46
Publisher:Middle East Society for Organ Transplantation
ISSN:1304-0855
OA Status:Closed
Publisher DOI:https://doi.org/10.6002/ect.2023.0338
PubMed ID:38742314