Key result
A review of 14 articles on direct oral anticoagulants in solid organ transplant patients found lacking strong evidence, indicating a need for caution and further study in larger randomized cohorts.
Systematic Review
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Current evidence for DOAC use in solid organ transplant patients is limited to small observational studies and case reports, warranting caution and further randomized trials.
Solid organ transplant patients are at risk of developing atrial fibrillation and venous thromboembolism. Direct oral anticoagulants are considered an attractive option for anticoagulation in patients due to their convenience; however, strong evidence of their use in transplantation is lacking. We conducted a search using Pubmed, Embase, and Scopus databases, in addition to International Society of Heart and Lung transplantation and American Transplant Congress abstracts (from 2012 through December 2017). Fourteen articles were reviewed that included case reports, retrospective case series, or chart review analyses of small cohorts. Based on this review, the findings can only generate hypotheses that should be further studied in a larger randomized cohort. This review can help clinicians gain insight into the use of direct oral anticoagulant in this special population. For now, clinicians should be cautious about their use in this special population.
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Alsheikh et al. (2018) conducted a systematic review in Solid organ transplant patients at risk of atrial fibrillation and venous thromboembolism. Direct oral anticoagulants was evaluated. A review of 14 articles on direct oral anticoagulants in solid organ transplant patients found lacking strong evidence, indicating a need for caution and further study in larger randomized cohorts.
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