#6698 THROMBOPROPHYLAXIS IN PEDIATRIC KIDNEY TRANSPLANTATION: A META-ANALYSIS

Abstract Background and Aims Kidney transplant patients are at higher risk for developing renal graft thrombosis, especially in pediatric patients. Renal graft thrombosis mainly causes graft failure leading to high morbidity, mortality, and a significant impact on quality of life. To minimize the risk of renal graft thrombosis, antithrombotic prophylaxis is widely used. However, the effect of antithrombotic prophylaxis for kidney transplantation is still a matter of discussion. Therefore, we carried out a meta-analytic synthesis to determine the effect of antithrombotic prophylaxis in pediatric kidney transplantation patients. Method We systematically searched MEDLINE, CENTRAL (Cochrane Central Register of Controlled Trials), and Web of Science. The eligible studies were identifying the incidence of renal graft thrombosis, hemorrhagic complication (bleeding and bleeding severity), and adverse outcomes related to antithrombotic prophylaxis compared with control group (placebo, active treatment, and no antithrombotic prophylaxis). Meta-analysis was carried out using Review Manager 5.3. The random-effects model was used to compute the pooled estimates of risk ratio (RR) and 95% confidence intervals (CI). Results A total of seven studies with 10,51 patients were included in the meta-analytic synthesis. Heparin was used across all the studies as the preferred antithrombotic prophylaxis. Results from the pooled meta-analysis reported that the overall risk for developing renal graft thrombosis was significantly lower in the antithrombotic prophylaxis group compared with the control group (RR = 0.81, 95% CI = 0.06-0.56, p = 0.003). There is no significant difference was found in incidence of hemorrhagic complications between antithrombotic prophylaxis and control group (RR = 0.81, 95% CI = 0.43-1.54). Similarly, there were no significant deaths were found in antithrombotic prophylaxis group compared with the control group (RR = 0.33, 95% CI = 0.01-22.45) Conclusion The results showed that antithrombotic prophylaxis significantly reduced the risk of renal graft thrombosis in pediatric kidney transplantation. However, due to limited outcomes, further real-world studies with long-term follow-up are required to generate sufficient data on the use of antithrombotic prophylaxis in pediatric kidney transplantation patients.