Efficacy and safety of non-vitamin K antagonist oral anticoagulants post-kidney transplantation

Table 1 Demographic characteristics of the patients

Age	No. patients	Age (yr, mean ± SD)	No. males	Weight	n	Estimated glomerular filtration rate
≤ 30	1	30	0	52	0	54
31-45	5	40.4 ± 5.86	2	96.20 ± 31.06	2	56.00 ± 18.67
46-60	8	56.4 ± 2.51	6	98.88 ± 29.79	3	65.13 ± 21.94
> 60	28	72.0 ± 6.71	17	78.25 ± 14.77	14	63.82 ± 18.88
Total	42	64.7 ± 13.88	25	83.69 ± 22.32	19	62.90 ± 18.98

Estimated glomerular filtration rate in (mL/min/1.73 m²).

Table 2 Clinical characteristics of the patient groups, n (%)

Variable	Age group (yr)		Total
	< 75	≥ 75
Primary cause of ESRD
Diabetic nephropathy	6 (19.4)	1 (9.1)	7 (16.7)
Hypertension	6 (19.4)	2 (18.2)	8 (19.0)
Glomerulonephritis	4 (12.9)	3 (27.3)	7 (16.7)
Polycystic kidney disease	6 (19.4)	2 (18.2)	8 (19.0)
Chronic Interstitial nephritis	3 (9.7)	1 (9.1)	4 (9.5)
Reflux/Congenital	3 (9.7)	2 (18.2)	3 (7.1)
Other	3 (9.7)	2 (18.2)	5 (11.9)
NOACs
Dabigatran 150 mg bid	1 (3.2)	1 (3.2)	2 (4.8)
Dabigatran-Low Dose	1 (3.2)	0 (0.0)	1 (2.4)
Apixaban 5 mg bid	11 (35.5)	1 (9.1)	12 (28.6)
Apixaban-Low Dose	10 (32.3)	7 (63.6)	17 (40.5)
Rivaroxaban 20 mg/d	5 (16.1)	0 (0.0)	5 (11.9)
Rivaroxaban Low Dose	3 (9.7)	2 (18.2)	5 (11.9)
Cause of NOAC initiation
VTE	8 (25.8)	2 (18.2)	10 (23.8)
AF	17 (54.8)	8 (72.7)	25 (59.5)
Other	2 (6.5)	0 (0)	2 (4.8)
VTE and AF	4 (12.9)	1 (9.1)	5 (11.9)
Calcineurin inhibitors
Advagraf	22 (71.0)	5 (45.5)	27 (64.3)
Prograf	3 (9.7)	1 (9.1)	4 (9.5)
Cyclosporin	1 (3.2)	4 (36.4)	5 (11.9)
Sirolimus	3 (9.7)	1 (9.1)	4 (9.5)
None	2 (4.8)	0 (0)	2 (4.8)
Clopidogrel
Yes	4 (12.9)	1 (9.1)	5 (11.9)
No	27 (87.1)	10 (90.9)	37 (88.1)

NOACs: Novel oral anticoagulants; VTE: Venous thromboembolism; AF: Atrial fibrillation; ESRD: End stage renal disease.

Table 3 Profile of the cases that developed bleeding

	Case 1	Case 2	Case 3
Age	77	73	87
Gender	Male	Female	Female
NOACs on use	Rivaroxaban	Apixaban	Apixaban
NOACs dose	15mg daily	2.5mg bid	2.5mg bid
Type of bleeding	Major	Non-major	Non-major
Site of bleeding	Intra-ocular	Bleeding per rectum	Bleeding per rectum
Time to bleed	> 1 yr post starting	> 1 yr post starting	> 1 yr post starting
Base line Cr/eGFR	93/72.6	67/79.5	122/38.44
Cr/eGFR at bleeding	144/38.6	58/93.9	147/31.0
CNI in use	Cyclosporin	Tacrolimus	Cyclosporin
CNI level at bleeding time	C0: 91	5.8 (within target)	C0: 116
Antiplatelet used	None	None	None
note	Rivaroxaban was on hold at the time of bleeding. Bled post cataract surgery.

NOACs: Novel oral anticoagulants; CR: Creatinine; eGFR: Estimated glomerular filtration rate; CNI: Calcineurin inhibitors.

Table 4 Profile of the immunosuppressive agents received according the type of Novel oral anticoagulants agent

NOAC	Calcineurin inhibitor used, n (%)					Total
	Advograf	Pyograf	Cycosporin	Sirolimus	None
Dabigatran 150 mg bid	2 (7.4)	0 (0)	0 (0)	0 (0)	0 (0)	2 (4.8)
Dabigatran-low dose	1 (3.7)	0 (0)	0 (0)	0 (0)	0 (0)	1 (2.4)
Apixaban 5 mg bid	8 (29.6)	1 (25.0)	0 (0)	2 (50.0)	1 (50.0)	12 (28.6)
Apixaban-low dose	10 (37.0)	2 (50.0)	3 (60.0)	2 (50.0)	0 (0)	17 (40.5)
Rivaroxaban 20 mg/d	4 (14.8)	1 (25.0)	0 (0)	0 (0)	0 (0)	5 (11.9)
Rivaroxaban low dose	2 (7.4)	0 (0)	2 (40.0)	0 (0)	1 (50.0)	5 (11.9)

All patients also received prednisolone and mycophenolate mofetil. NOACs: Novel oral anticoagulants.