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  • Title: Clopidogrel use as a risk factor for poor outcomes after kidney transplantation.
    Author: Williams JM, Tuttle-Newhall JE, Schnitzler M, Dzebisashvili N, Xiao H, Axelrod D, Mogal H, Lentine KL.
    Journal: Am J Surg; 2014 Oct; 208(4):556-62. PubMed ID: 25241952.
    Abstract:
    BACKGROUND: Limited data are available on outcome implications of clopidogrel use before kidney transplantation. METHODS: A novel dataset linking national transplant registry data with records from a large pharmacy claims clearinghouse (2005 to 2010) was examined to estimate risks of post-transplant death and graft failure associated with clopidogrel fills within 90 or more than 90 days before transplant. RESULTS: Clopidogrel fills within 90 days of transplant were associated with 61% of increased relative mortality risk and 23% of increased graft failure risk. Risks were higher in those whose last clopidogrel fill was more than 90 days before transplantation (111% for death, 59% for graft loss). Adverse prognostic associations persisted among recipients of live and deceased donor allografts, older recipients, and those with diabetes or reported cardiovascular disease. CONCLUSIONS: Clopidogrel use before kidney transplantation portends increased risks of post-transplant death and graft loss. Pharmacy claims may identify novel prognostic markers not currently captured in the transplant registry.
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