AFP reports that New Zealand rugby great Jonah Lomu probably died from a blood clot that formed while he was on a long-haul flight from the UK via Dubai to New Zealand.
He was apparently in good health when he arrived in New Zealand, but died at his home on 18 November, mere weeks after he watched New Zealand take the the Rugby World Cup on 31 October.
Doctor John Mayhew, a former All Blacks team doctor and who helped treat Lomu for chronic kidney disease, said that a venous thromboembolism (aka VTE, a blood clot in the vein) was the most likely explanation for his sudden death aged just 40.
He also said that the most likely cause was due to the formation of a clot in the lung.
Lomu's kidney problems
Lomu suffered from the rare kidney disorder called nephrotic syndrome and was diagnosed with the condition in 1995 while he was still playing rugby.
Nephrotic syndrome is a condition marked by very high levels of protein in the urine, low levels of protein in the blood, high cholesterol and swelling around the eyes, feet and hands.
Lomu underwent his first kidney transplant on July 28, 2004, the year after he played his final game for the All Blacks.
In 2011 his body rejected the replacement kidney and the disease took over again.
He was placed on kidney dialysis, six hours at a time, to cleanse his blood.
While the condition can lead to blood clots, infection and kidney failure, patients with nephrotic syndrome are at increased risk for venous thrombosis, particularly deep vein and renal vein thrombosis (DVT and RVT).
He said it's likely that Lomu 'didn't know what hit him' when it happened, and that it's just one of those tragic complications that can occur in people with chronic renal conditions.
"I'm really lucky, I've already lived more in one lifetime than many would in six or seven lifetimes. The thing about being human is that everybody has to die sometime. For me, the important thing is to ask 'can you look in the mirror and say you done everything to enjoy life?'
Long-haul flights and clots
Long-haul flights, defined as any trip lasting eight hours or more, are known to increase the risk of a potentially fatal blood clot forming, especially in the legs.
The risk of these blood clots is quadrupled during long flights for the average person, while people with conditions that promote blood clotting are at even greater risk.
Although VTE is a dangerous – and potentially fatal condition – the good news is that it affects only a relatively small number of travellers. The absolute risk, if seated and immobile for more than four hours, is about 1 in 6 000.
According to the World Health Organisation (WHO), the condition becomes
life-threatening when a blood clot in a leg vein breaks off and travels
through the body to the lungs where it becomes lodged and blocks blood
flow. Symptoms of so-called pulmonary embolism include chest pain and
According to the WHO, the following factors increase your risk of DVT:
- being seated and immobile for more than four hours while travelling by plane, train, bus or automobile;
- taking multiple flights over a short period of time (the risk remains elevated for about four weeks after a flight);
- being very tall or very short (taller than 1,9m or shorter than 1,6m);
- use of oral contraceptives;
- inherited blood disorders leading to increased clotting tendency.
Additional sources: Government of Victoria, Llach F. Hypercoagulability, renal vein thrombosis, and other thrombotic complications of nephrotic syndrome. Kidney Int 1985; 28:429.