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논문분류	춘계학술대회 초록집
제목	Hemodialysis catheter-related right atrial thrombus detected prior to kidney transplantation
저자	Soomin JEUNG1, *Su-kil PARK2
출판정보	2017; 2017(1):
키워드	anticoagulation, echocardiography, hemodialysis catheter-related right atrial thrombus, kidney transplantation
초록	Objectives : This study was performed to review the clinical characteristics and KT outcome of patients with hemodialysis catheter-related RAT detected prior to KT, and to speculate the clinical significance of the condition. Methods : Among patients who underwent KT during January 1995 and September 2015 in Asan medical center, those who had a history of hemodialysis catheter-related RAT prior to KT were included to the study. Their medical records were retrospectively reviewed regarding clinical characteristics, management, and KT outcome . Results : During the study period, 3,929 cases of KT were performed in 3,829 patients. A total of 11 patients were found to have a history of hemodialysis catheter-related RAT prior to KT. Nine (81%) of the 11 patients had no symptoms associated with RAT. 81% had their catheter tips positioned in the right atrium (RA). The average maximal diameter of the RAT was 23.2 ± 16.3 (SD) mm. Four (36%) patients had their catheter replaced. Five patients (45%) had their catheter removed. Two patients (18%) kept their catheters in place. Six (54%) patients were anticoagulated. Among them, one patient had surgical site bleeding and had to return to the operating room for bleeding control. All patients had successful KT outcome, without any complications related to thrombus after KT. Conclusions : Hemodialysis catheter-related RAT that is unexpectedly detected prior to KT may not be as fatal as previously considered. Asymptomatic hemodialysis catheter-related RAT should not be a reason for delay or cancellation of KT. It can be managed with replacement or removal of the catheter. Additional anticoagulation may be needed when the size of RAT is larger. We suggest anticoagulation in RAT with maximal length larger than 15 mm. Long term anticoagulation after the disappearance of RAT seems to be unnecessary.
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