{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T00:08:04Z","timestamp":1781914084231,"version":"3.54.5"},"reference-count":48,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,4,7]],"date-time":"2021-04-07T00:00:00Z","timestamp":1617753600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>RGT is a major cause for early graft loss after KTx. Although evidence\u2010based recommendations are lacking, aP is often used to prevent RGT. This systematic review aimed to determine the effectiveness and safety of aP in adult and pediatric KTx recipients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>MEDLINE, EMBASE, Cochrane Controlled Trials Register, conference proceedings, and electronic databases for trial registries were searched for eligible studies using search terms relevant to this review (April 21, 2020). The systematic review was carried out following the recommendations of the Cochrane Collaboration and the Prefered Reporting Items for Systematic Reviews and Meta\u2010Analyses (PRISMA) Statement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twelve studies comprising 2370 patients (adult\u00a0=\u00a01415, pediatric\u00a0=\u00a0955) were included, of which three were RCTs. The overall risk for developing RGT was lower in the group with aP compared with the control group (RR 0.24, 95% confidence interval 0.12\u20130.49). The antithrombotic drugs used were heparin (7\/12), acetylsalicylic acid (2\/12), a combination of both (2\/12), and dipyridamole (1\/12) with a high variability in timing, dosing, and mode of application. Adverse effects were reported rarely, with minor bleeding as the main complication. The non\u2010randomized studies had significant risks of bias in the domains of patient selection, confounder, and measurement of outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Based on pooled analysis, aP seems to reduce the risk of RGT in KTx. However, the reliability of these results is limited, as the quality of the available studies is poor and information on adverse effects associated with aP is scarce. Additional high\u2010quality research is urgently needed to provide sufficient data supporting the use of aP in KTx.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14021","type":"journal-article","created":{"date-parts":[[2021,4,7]],"date-time":"2021-04-07T13:37:01Z","timestamp":1617802621000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Prophylactic antithrombotic management in adult and pediatric kidney transplantation: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4337-8663","authenticated-orcid":false,"given":"Sascha","family":"Bapistella","sequence":"first","affiliation":[{"name":"Department of General Pediatrics and Haematology\/Oncology University Children\u2019s Hospital Tuebingen Tuebingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Zirngibl","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics and Haematology\/Oncology University Children\u2019s Hospital Tuebingen Tuebingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathrin","family":"Buder","sequence":"additional","affiliation":[{"name":"Pediatric Nephrology Department University Children\u2019s Hospital Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikan","family":"Toulany","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics and Haematology\/Oncology University Children\u2019s Hospital Tuebingen Tuebingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido F.","family":"Laube","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Children\u2019s Hospital Baden Baden Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1696-5646","authenticated-orcid":false,"given":"Marcus","family":"Weitz","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics and Haematology\/Oncology University Children\u2019s Hospital Tuebingen Tuebingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,4,7]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/tri.13387"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1603364"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2005.01213.x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.13597"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2018.01.027"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.ndt.a027030"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/793461"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2006.12.017"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.6002\/ect.2018.0358"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2012.05.048"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/15.11.1865"},{"key":"e_1_2_10_13_1","first-page":"196","article-title":"Survey of thromboprophylaxis strategies in renal transplant recipients at a single transplant unit","volume":"185","author":"Kohli R","year":"2019","journal-title":"Br J Haematol"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.13799"},{"key":"e_1_2_10_15_1","volume-title":"CRD's Guidance for Undertaking Reviews in Healthcare","author":"Reviews Cf, Dissemination","year":"2009"},{"key":"e_1_2_10_16_1","first-page":"ED000142","article-title":"Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions","volume":"10","author":"Cumpston M","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000100"},{"key":"e_1_2_10_18_1","unstructured":"BapistellaS WeitzM.Prophylactic antithrombotic management strategies in kidney transplantation: a systematic review. In. PROSPERO 2020 CRD42020165445. Available fromhttps:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?ID=CRD42020165445"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"e_1_2_10_20_1","article-title":"ROBINS\u2010I: a tool for assessing risk of bias in non\u2010randomised studies of interventions","volume":"355","author":"Sterne JA","year":"2016","journal-title":"BMJ"},{"key":"e_1_2_10_21_1","first-page":"1","article-title":"Risk\u2010of\u2010bias VISualization (robvis): An R package and Shiny web app for visualizing risk\u2010of bias assessments","author":"McGuinness LA","year":"2020","journal-title":"Res Syn Meth"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.2307\/2530643"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1186"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"issue":"3","key":"e_1_2_10_26_1","first-page":"40","article-title":"meta: An R package for meta\u2010analysis","volume":"7","author":"Schwarzer G","year":"2007","journal-title":"R News"},{"issue":"6","key":"e_1_2_10_27_1","first-page":"397","article-title":"Prevention of vascular thromboses after renal transplantation using low molecular weight heparin","volume":"38","author":"Broyer M","year":"1991","journal-title":"Ann Pediat"},{"issue":"5","key":"e_1_2_10_28_1","first-page":"S103","article-title":"Transplanting the high\u2010risk pediatric end\u2010stage renal disease population: an anticoagulation protocol to reduce renal graft loss secondary to thrombosis","volume":"10","author":"Dubow B","year":"2016","journal-title":"Can Urol Assoc J"},{"issue":"2","key":"e_1_2_10_29_1","first-page":"141","article-title":"Protective effect of heparin and aspirin against vascular thrombosis in pediatric kidney transplants","volume":"6","author":"Esfandiar N","year":"2012","journal-title":"Iran J Kidney Dis"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.13512"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2168.2001.01671.x"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-004-1458-4"},{"issue":"5","key":"e_1_2_10_33_1","first-page":"255","article-title":"The effect of dipyridamole on the results of allogenic kidney transplantation","volume":"83","author":"Schulze R","year":"1990","journal-title":"Zeitschrift Urol Nephrol"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-198911000-00038"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.6381"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0041-1345(99)00747-2"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-2404"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-2308"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2018.07.041"},{"issue":"3","key":"e_1_2_10_40_1","first-page":"253","article-title":"Activated partial thromboplastin time monitoring of unfractionated heparin therapy: issues and recommendations","volume":"43","author":"Marlar RA","year":"2017","journal-title":"Semin Thromb Hemost"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2017.03.008"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.3636"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2019.10.022"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2020.05.013"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.13006"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-018-3895-5"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1177\/1076029620929092"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1614394"}],"container-title":["Pediatric Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.14021","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/petr.14021","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.14021","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T13:21:27Z","timestamp":1693574487000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/petr.14021"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,7]]},"references-count":48,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,6]]}},"alternative-id":["10.1111\/petr.14021"],"URL":"https:\/\/doi.org\/10.1111\/petr.14021","archive":["Portico"],"relation":{},"ISSN":["1397-3142","1399-3046"],"issn-type":[{"value":"1397-3142","type":"print"},{"value":"1399-3046","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,7]]},"assertion":[{"value":"2020-12-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-04-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14021"}}