Antiphospholipid antibodies - Risk assessments for solid organ, bone marrow, and tissue transplantation

The literature describing the outcome of solid-organ, bone marrow, prosthetic, and tissue grafts for antiphospholipid antibody (aPL) positive patients is reviewed and discussed. Authors of most reports agree that the presence of aPL in transplant candidates or in transplant recipients are cause for concern. A significantly higher percentage of aPL positive patients lose their grafts to thrombosis in the first days to weeks posttransplant. Perioperative and postoperative treatment of aPL positive patients with anticoagulant therapy can reduce or eliminate this thrombotic tendency. Allogeneic, as opposed to autologous bone marrow transplantation, is by definition a unique circumstance because the recipient undergoes complete immunological reconstitution.