Introduction: Antiplatelet drugs cannot be stopped at the time of transplantation in some recipients with coronary artery disease (CAD). This may increase peri-operative bleeding. We have analyzed our experience.

Methods: We retrospectively analyzed data of recipients with CAD, taking DAPT (Clopidogrel 75 mg and Acetylsalicylic acid 150 mg). Based on pre-operative evaluation by cardiologist, patients were segregated into two groups: Group-A (drugs discontinued 5 days prior to procedure), Group-B (drugs continued, because of high risk of acute coronary event, on discontinuation). Both groups were analyzed with respect to age, body mass index, pre and postoperative hemoglobin (post-operative day one), intra-operative blood loss, drain output (DO), need for blood transfusion (BT), bleeding complications (need for any intervention), any cardiovascular event upto one month follow-up. Continuous variables were compared using Mann Whitney-U test and dichotomous variables analyzed using Chi-Square test, p-value of 0.05 considered significant.

Results: From December 2014 to January 2021, 106 patients were identified, (Group A = 73, Group B = 33). These groups were comparable in terms of all the listed parameters except significantly higher DO in Group B, Table 1. No adverse cardiovascular event was noted. No patient required any intervention for bleeding.

Conclusions: With proper attention to intra-operative hemostasis, transplants can be performed safely in patients on DAPT.

Table 1. Peri-operative parameters. @: Median + Interquartile range; *: Chi Square; **: Mann Whitney U.