Immune modulating drugs and oral anticoagulation in kidney transplant recipients: comparison of direct oral anticoagulants versus antagonist of vitamin-k. results from a multicenter prospective study

Abstract Funding Acknowledgements Type of funding sources: None. Background direct oral anticoagulants (DOACs) are a well-known alternative to conventional antagonist vitamin-K (avK) and have emerged as the preferred choice due their safety efficacy profile. However, immune modulating drugs cyclosporine tacrolimus, commonly used for transplant recipients, may interfere with DOACs. Aim this study: evaluate profile compared warfarin in kidney recipients (KTRs) treated agents. Methods multi-center study from 4 Italian hospitals enrolling KTRs on DOACs or avK was carried out. Sixty-nine patients were fifty mean estimated glomerular filtrate rate (eGFR) > 45 mL/min. Clinical follow-up serial evaluation renal function serum levels during 24 months (FU) performed. Results Mean age 67±9 eGFR was57±20 Immune-modulating therapy included tacrolimus (n=47, 71%), cyclosporin (n=13, 20%), everolimus (n=10, 7%) sirolimus (n=4, 6%). There no changes Tacrolimus Cyclosporin following 14 days (+0.5 ±2 +28 ±31, p=0.52, 0.90, respectively) only patient dabigatran 150 mg required dose adjustment. Levels stable at follow-up. At long-term follow-up, there thromboembolic events among differences term mayor bleeding (5.8% vs 4% p=0.99). difference decline start FU between (-3.9±1 -3.8±2 p=0.82) (FIGURE 1). Conclusion potential therapeutic option drugs. Careful immunomodulating agent first two week should be recommended. No bleeding, found when comparing therapy.