Management of Antithrombotic Therapies in Kidney Transplantation Candidates and Recipients: An ERBP (European Renal Best Practice) Clinical Practice Document by the Descartes Working Group of the European Renal Association (ERA) and the Ekita Committee of the European Society of Organ Transplantation (ESOT)

Abstract Thromboembolic and atherosclerotic disorders, necessitating antithrombotic therapies, are prevalent among patients with advanced chronic kidney disease (CKD), as well as in kidney transplant (KT) recipients. However, the optimal management of antithrombotic therapies in these patients remains uncertain due to conflicting evidence and the exclusion of advanced CKD and KT recipients from major randomized controlled trials. Additionally, the perioperative management of antithrombotic therapy in end-stage kidney disease patients undergoing transplantation requires specific attention. This clinical practice document prepared by experts from the Descartes Working Group of the European Renal Association (ERA) and European Kidney Transplant Association (EKITA) from European Society of Organ Transplantation (ESOT) following European Renal Best Practice (ERBP) guidelines, is designed to support clinicians in decision making on antithrombotic therapies in KT candidates and recipients. Following a detailed systematic literature review, it presents current knowledge in epidemiology and pathophysiology and summarizes all relevant studies in this topic.