Case Report: Hemolytic Anemia Following Deceased Donor Renal Transplantation Associated With Tranexamic Acid Administration for Disseminated Intravascular Coagulation.

Abstract Background Long-term outcomes of kidney transplantation with organs from donors with disseminated intravascular coagulation (DIC) are comparable with those from other deceased donors. The use of tranexamic acid to impair fibrinolysis in the treatment of DIC is becoming increasingly frequent, particularly in the trauma setting. However, the effects of tranexamic acid on a transplanted kidney allograft are unknown. Results We report 2 cases of kidney transplantation following administration of tranexamic acid to the donor prior to organ donation. Microthrombi were present in the renal allografts. Both recipients experienced clinically significant hemolytic anemia, which typically occurs at a very low frequency. Conclusions These cases illustrate a potential concern for the use of tranexamic acid in deceased kidney donors with DIC.