Role of inferior vena cava filters in transplant patients

Clin Transplant. 2017 Feb;31(2). doi: 10.1111/ctr.12865. Epub 2017 Jan 13.

Abstract

Purpose: This study evaluates the selection, use, and risks of permanent and retrievable inferior vena cava filters (IVCFs) in patients who have undergone organ transplantation.

Materials and methods: Single-center retrospective review of 35 patients who had an IVCF placed following organ transplantation. Patient demographics, IVCF indication, and eligibility for retrieval were reviewed. Computed tomography (CT) studies showing the filter (n=22) were evaluated independently for IVCF adverse effects.

Results: Thirty-two (91%) of 35 patients had retrievable IVCFs placed while three (9%) patients received permanent IVCFs. Filter retrieval was indicated in three of the 32 patients receiving retrievable filters and was performed in two cases. Patients were ineligible for retrieval due to short life expectancy, complications/contraindications to anticoagulation, extended filter dwell time, lost to follow-up, and undetermined therapeutic value of anticoagulation.

Conclusion: Current practices of filter placement usually dictate placing a retrievable IVCF in transplant patients. However, transplant patients are unlikely to be eligible for filter retrieval especially in situations of advanced age and comorbidities. Given the low incidence of eligibility for retrieval in this patient population, these results suggest preferential placement of permanent filters may reduce the potential morbidity due to filter-related complications, such as strut perforation, in transplant patients.

Keywords: deep venous thrombosis; inferior vena cava filter; pulmonary embolism; retrieval; transplant.

MeSH terms

  • Device Removal
  • Female
  • Follow-Up Studies
  • Graft Rejection / etiology
  • Graft Rejection / prevention & control*
  • Graft Survival
  • Humans
  • Male
  • Middle Aged
  • Organ Transplantation / adverse effects*
  • Postoperative Complications / prevention & control*
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Vena Cava Filters / statistics & numerical data*
  • Vena Cava, Inferior
  • Venous Thromboembolism / prevention & control*