| Characteristic | Transplant before, N = 1801 | Transplant after, N = 511 | p-value2 |
|---|---|---|---|
| Age (years) | 55 (46, 64) | 59 (51, 64) | 0.12 |
| Sex | 0.8 | ||
| Female | 53 (29%) | 14 (27%) | |
| Male | 127 (71%) | 37 (73%) | |
| BMI (kg/m2) | 26.0 (22.0, 31.0) | 29.0 (27.0, 32.0) | <0.001 |
| Indication | <0.001 | ||
| TRAS | 41 (23%) | 1 (2.0%) | |
| Hepatic artery stenosis | 39 (22%) | 0 (0%) | |
| GIB | 33 (18%) | 5 (9.8%) | |
| Other bleed | 40 (22%) | 11 (22%) | |
| Other | 12 (6.7%) | 21 (41%) | |
| Diagnostic | 15 (8.3%) | 13 (25%) | |
| Organ | <0.001 | ||
| Kidney | 74 (41%) | 7 (14%) | |
| Liver | 95 (53%) | 44 (86%) | |
| Other (e.g. pancreas) | 11 (6.1%) | 0 (0%) | |
| On steroids within 30 days of procedure | 165 (92%) | 14 (27%) | <0.001 |
| Any antiplatelet therapy within 72 hrs | 105 (58%) | 11 (22%) | <0.001 |
| Any blood thinner within 72 hrs | 30 (17%) | 5 (9.8%) | 0.2 |
| Hydrocortisone equivalent dose (mg) | 40 (20, 80) | 1,173 (120, 1,333) | <0.001 |
| Unknown | 18 | 38 | |
| Sheath size | 0.013 | ||
| 4Fr | 2 (1.1%) | 0 (0%) | |
| 5Fr | 125 (71%) | 47 (92%) | |
| 6Fr | 41 (23%) | 4 (7.8%) | |
| 7Fr | 8 (4.5%) | 0 (0%) | |
| 8Fr | 0 (0%) | 0 (0%) | |
| Unknown | 4 | 0 | |
| Closure | 0.2 | ||
| Angioseal | 157 (87%) | 41 (80%) | |
| Perclose | 3 (1.7%) | 1 (2.0%) | |
| Mynx | 8 (4.4%) | 1 (2.0%) | |
| Manual pressure | 9 (5.0%) | 4 (7.8%) | |
| Other | 3 (1.7%) | 4 (7.8%) | |
| Antiplatelet therapy within 72 hrs | <0.001 | ||
| None | 75 (42%) | 40 (78%) | |
| ASA 81 | 57 (32%) | 11 (22%) | |
| ASA 325 | 20 (11%) | 0 (0%) | |
| DAPT | 21 (12%) | 0 (0%) | |
| Other | 7 (3.9%) | 0 (0%) | |
| Blood thinner | 0.2 | ||
| Warfarin | 14 (7.8%) | 5 (9.8%) | |
| DOAC | 13 (7.2%) | 0 (0%) | |
| Bivalirudin | 0 (0%) | 0 (0%) | |
| Other | 3 (1.7%) | 0 (0%) | |
| None | 150 (83%) | 46 (90%) | |
| Periprocedural heparin gtt within 72 hrs | 26 (14%) | 2 (3.9%) | 0.042 |
| Intraprocedural heparin | 33 (18%) | 2 (3.9%) | 0.011 |
| Hypertensive SBP ≥ 180 and DBP ≥ 95 within 72 hrs | 30 (17%) | 6 (12%) | 0.4 |
| Type of bleeding event | >0.9 | ||
| Pseudoaneurysm | 11 (6.1%) | 2 (3.9%) | |
| Dissection | 3 (1.7%) | 0 (0%) | |
| Hematoma w/o documented psuedoaneurysm | 9 (5.0%) | 2 (3.9%) | |
| Other (AVF, true aneurysm) | 0 (0%) | 0 (0%) | |
| None | 157 (87%) | 47 (92%) | |
| Bleeding event within 30 days | 23 (13%) | 4 (7.8%) | 0.3 |
| 1 Median (IQR); n (%) | |||
| 2 Wilcoxon rank sum test; Pearson’s Chi-squared test; Fisher’s exact test | |||
Retrospective review of femoral access bleeding events among transplant patients
Statistical analysis
Categorical variables were summarized as counts and percentages, and continuous variables were summarized as means and standard deviations. Comparisons between groups were performed using chi-square or Fisher’s exact tests for categorical variables and Wilcoxon rank sum test for continuous variables. A p-value of <0.05 was considered statistically significant. All analyses were conducted using R (version 4.2.3).
Results
Transplant status and bleeding events
Patient characteristics and outcomes are summarized in Table 1 by transplant status.
- Transplant before procedure: 23/180 (12.8%) had bleeding events.
- Transplant after procedure: 4/51 (7.8%) had bleeding events.
- The difference is not statistically significant (p = 0.333).
By bleeding status
Table 2 shows the association of immunosuppression, hypertension, anticoagulation, and heparin use with bleeding events.
| Characteristic | No, N = 2041 | Yes, N = 271 | p-value2 |
|---|---|---|---|
| On steroids within 30 days of procedure | 156 (76%) | 23 (85%) | 0.3 |
| Hypertensive SBP ≥ 180 and DBP ≥ 95 within 72 hrs | 31 (15%) | 5 (19%) | 0.6 |
| Any antiplatelet therapy within 72 hrs | 103 (50%) | 13 (48%) | 0.8 |
| Any blood thinner within 72 hrs | 31 (15%) | 4 (15%) | >0.9 |
| Periprocedural heparin gtt within 72 hrs | 25 (12%) | 3 (11%) | >0.9 |
| Intraprocedural heparin | 27 (13%) | 8 (30%) | 0.041 |
| 1 n (%) | |||
| 2 Pearson’s Chi-squared test; Fisher’s exact test | |||