Deep Vein Thrombosis after COVID-19 mRNA Vaccination in a Young Man with Inferior Vena Cava Anomaly Leading to Recurrent Deep Vein Thrombosis.

Severe side effects of adenoviral-vectored-DNA COVID-19 vaccines such as thrombosis have been reported. Herein, we report a case of sudden massive deep vein thrombosis (DVT) in a young man with inferior vena cava anomaly 20 hours after the second dose of the mRNA vaccine for COVID-19. There was recurrence of iliofemoral DVT after one year, despite complete resolution and administration of prophylactic anticoagulants. We suggest that the sudden episode was triggered by the vaccine rather than the venous anomaly, which can be associated with recurrence due to inadequate venous return through the small and tortuous infrarenal veins or increased venous pressure and stasis. There are no standard guidelines for the management of DVT following mRNA vaccination. However, we highlight the importance of initial workups, regular follow-ups, and standard treatment options, including the continuous administration of prophylactic anticoagulants which should be considered to prevent recurrence.

Clinical outcomes of the first 300 cases of kidney transplantation: a single-center retrospective cohort study.

Background: Kidney transplantation (KT) is regarded as the most effective treatment for end-stage renal disease. The annual number of KT cases in South Korea has increased rapidly as more centers are implementing a transplantation program. The objective of this study was to determine clinical outcomes of the first 300 consecutive cases of KT in a single center. Methods: Clinical data of 300 cases of KT at Seoul National University Bundang Hospital from January 2004 to March 2018 were obtained from a prospectively collected database and retrospectively reviewed. Results: The mean age of patients was 47.7±12.9 years, and 59% of patients were male. There were 225 living donors and 75 deceased donors. A total of 42 cases were from ABO-incompatible donors. During a mean follow-up of 68.6±43.5 months, 38 patients (12.7%) experienced rejection. The most common cause was acute T-cell mediated rejection (9.0%). Eighteen patients experienced graft loss. One-year and 5-year death-censored graft survival rates were 99% and 96.6%, respectively. One-year and 5-year patient survival rates were 98.3% and 96.6%, respectively. Multivariate analysis revealed that graft weight-to-recipient weight ratio and rejection were significant factors affecting graft survival. Conclusions: This single-center review demonstrates clinical outcomes comparable to other major centers. Such good outcomes were obtained by good patient selection, dedicated transplant physicians, and adequate use of immunosuppressive therapy.