Table 1 Risk factors of and interventions for preventing allograft infarction during IVIG administration in kidney transplant recipients
Risk factors | Preventive interventions during IVIG | Diagnosis |
|---|---|---|
Old age (> 45 years old) | Hydration before and after administration | Dopplex ultrasound |
History of prior thrombotic events | Slow infusion | Contrast enhanced CT |
Immobilization | Limitation of daily dose of IVIG (< 400-500 mg/kg) | Radioisotope scan |
Allograft causes | Use of aspirin or LMWH (considering risk vs. benefit) | Angiography |
Arterial kinking or torsion | ||
End-to-end anastomosis of artery | ||
Multiple renal arteries of allograft | ||
Trauma | ||
Hypercoagulability | ||
Infection (esp, sepsis) | ||
Hypotension | ||
Hemolytic uremic syndrome | ||
Drugs (e.g., cyclosporine, oral contraceptives) | ||
Antiphospholipid syndrome | ||
Genetic mutations (e.g., factor V Leiden) | ||
Comorbidities | ||
Cardiac problem (e.g., atrial fibrillation) | ||
Atherosclerosis | ||
Renal artery stenosis | ||
Diabetes mellitus | ||
Hypertension | ||
Vasculitis associated with endothelial damage | ||
Nephrotic syndrome | ||
Increased intra-renal pressure | ||
Acute tubular necrosis | ||
Hydronephrosis | ||
Acute rejection | ||