Hemorrhagic complications of enoxaparin and aspirin in patients with kidney transplants

Pharmacotherapy. 2002 Feb;22(2):184-7. doi: 10.1592/phco.


Study objective: To evaluate the frequency of early posttransplant hemorrhagic complications in patients with kidney and kidney-pancreas transplants who received thromboprophylaxis with enoxaparin and aspirin.

Design: Retrospective chart review.

Setting: University-based tertiary care center.

Patients: Thirteen patients who had received enoxaparin within 10 days of kidney or kidney-pancreas transplantation.

Intervention: Medical records were reviewed, and data from patients who had received low-dose aspirin 81 mg once/day and enoxaparin within 10 days of transplantation were collected.

Measurements and main results: Major bleeding events were defined as intracranial or retroperitoneal bleeding, or a decrease in hemoglobin of greater than 2 g/dl that was confirmed on repeat evaluation. Nine (69%) of the 13 patients had confirmed major bleeding events and required blood transfusions. Six of the nine patients had elevated serum creatinine levels.

Conclusion: The combination of enoxaparin and low-dose aspirin early after kidney or kidney-pancreas transplantation was associated with a high frequency of hemorrhagic events. Further evaluation is needed to determine the safety of enoxaparin in combination with aspirin after transplantation.

MeSH terms

  • Adult
  • Aged
  • Anticoagulants / adverse effects*
  • Anticoagulants / therapeutic use
  • Aspirin / adverse effects*
  • Aspirin / therapeutic use
  • Drug Therapy, Combination
  • Enoxaparin / adverse effects*
  • Enoxaparin / therapeutic use
  • Female
  • Fibrinolytic Agents / adverse effects*
  • Fibrinolytic Agents / therapeutic use
  • Hemoglobins / analysis
  • Humans
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Pancreas Transplantation
  • Postoperative Hemorrhage / chemically induced*
  • Retrospective Studies


  • Anticoagulants
  • Enoxaparin
  • Fibrinolytic Agents
  • Hemoglobins
  • Aspirin