Haematologica 2004;89: supplement no. 8 - Supplements ...

14Selected Oral Communications11-84); the median time between the first VTE andrecurrence or referral to our center was 3 years (A,range 1-21), 4 (B, range 1-40), and 5 (C, range 1-41).Patients with multiple defects had an increased riskfor recurrent VTE in comparison with patients withnormal genotype (hazard ratio 1.9, 95% CI 1.1-3.5);the risk for spontaneous recurrence after a first spontaneousVTE was 2.9-fold increased (95% CI 1.1-7.5).On the opposite, the risk for recurrence was notincreased among patients with deficiency of AT, PC,or PS in comparison with the reference group (hazardratio 1.2, 95% CI 0.7-2.2); after stratificationaccording to the circumstances of the first or therecurrent event the risk for spontaneous recurrenceafter a first spontaneous VTE was increased withoutreaching statistical significance (hazard ratio 1.8,95% CI 0.8-4.3). Therefore patients with PC or PSdeficiency do not seem firm candidates to long-termanticoagulation after a first VTE. The number ofpatients with AT deficiency is too low to draw anyconclusion: however the rate of spontaneous recurrenceafter a first spontaneous VTE was 67% (2 of 3)in them and 36% (4 of 11) in patients with PC or PSdeficiency. Further multicenter investigations arewarranted.COS-07HIGH RISK OF VENOUS THROMBOEMBOLIC RECURRENCE INRENAL TRANSPLANT RECIPIENTS: ROLE OFHYPERHOMOCYSTEINEMIA AND CLOTTING ACTIVATIONMARKERSPoli D, Antonucci E, Cecchi E, Marcucci R, Lapini I,Lari B, Lenti M, Zanazzi M,* Salvadori M,* Abbate R,Gensini GF, Prisco DCentro di Riferimento Regionale per la Trombosi,Dipartimento dell’ Area Critica Medico Chirurgica,*UO Nefrologia e Trapianti Azienda Ospedaliero-Universitaria Careggi, Florence, ItalyRenal transplantation is associated with anincreased risk of venous thromboembolism (VTE). Nodata are available about the optimal duration of oralanticoagulant therapy (OAT) in renal transplant (RT)recipients. Our study was performed to evaluate therisk of VTE recurrence in patients developing a firstepisode of VTE after RT. We prospectively studied 28RT recipients who had suffered from a first episodeof VTE after stopping OAT (Group 1). Group 1 wascompared with a group of 84 patients without historyof renal disease who had suffered from a firstepisode VTE matched for age, sex and type of thromboticevent (Group 2) and with a matched group of28 RT recipients without history of VTE (Group 3).After OAT withdrawal, thrombophilia (AT, protein C,protein S, prothrombin gene variant, factor V Leiden,homocysteinemia) and clotting activation markers(prothrombin fragment 1+2 (F1+2) and D-dimerplasma levels) were evaluated. During follow-up,14/28 patients of Group 1 and 8/84 patients ofGroup 2 experienced VTE recurrence (p=0.0001). Asthrombophilia is concerned, no difference was foundamong the 3 groups, except for homocysteine.Hyperhomocysteinemia was found in 24/28 Group 1patients, in 23/84 Group 2 patients (p