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Updated: Jun 17, 2026
A Rat Orthotopic Renal Transplantation Model for Renal Allograft Rejection
Published on: February 2, 2022
Angiotensin blockade is associated with early graft dysfunction after live donor renal transplantation
Kathryn K Stevens1, Rajan K Patel, Marc Clancy
1Renal Transplant Unit, Western Infirmary, Glasgow, United Kingdom. kathrynstevens2@nhs.net
Background:
Activation of the renin angiotensin system may contribute to the development of delayed graft function after renal transplantation. We, therefore, examined the impact of pretransplant treatment with blockers of the renin angiotensin system on early graft function after renal transplantation.
Method:
The case records of all patients who received a live donor transplant between January 2001 and August 2008 were reviewed.
Results:
Serum creatinine measurements were recorded for the first nine posttransplant days, in 94 recipients of live donor kidneys, where there were neither surgical nor hemodynamic complications and no documented rejection or infection. Forty patients (43%) were treated with a blocker of the renin-angiotensin-aldosterone system before transplantation. Serum creatinine levels fell more slowly in these patients (P=0.02). Two patients required hemodialysis after transplantation; both were on an angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker.
Conclusion:
Live donor renal transplant recipients who are taking a renin-angiotensin-aldosterone system blocker at the time of transplantation are more likely to have impaired graft function postoperatively in the absence of other explanations. This observation requires further exploration in live and deceased donor renal transplantation.
Insights
Patients taking renin-angiotensin-aldosterone system blockers before kidney transplants experienced slower graft function recovery. This suggests potential risks associated with these medications in renal transplantation.
Area of Science:
- Nephrology
- Transplantation Immunology
- Pharmacology
Background:
- Renin-angiotensin system (RAS) activation is implicated in delayed graft function post-renal transplant.
- Investigating pretransplant RAS blockade impact on early renal allograft function is crucial.
Purpose of the Study:
- To evaluate the effect of pretransplant renin-angiotensin-aldosterone system (RAAS) blockers on early graft function in live donor renal transplant recipients.
Main Methods:
- Retrospective review of case records for live donor kidney transplant recipients (January 2001 - August 2008).
- Analysis of serum creatinine levels for the first nine posttransplant days in 94 patients without surgical, hemodynamic, rejection, or infection complications.
Main Results:
- Forty-three percent of patients received RAAS blockers pre-transplant.
- Patients on RAAS blockers exhibited slower serum creatinine decline (P=0.02).
- Two patients requiring hemodialysis were on angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers.
Conclusions:
- Pretransplant RAAS blocker use in live donor renal transplant recipients is associated with impaired postoperative graft function.
- This finding warrants further investigation in both live and deceased donor renal transplantation settings.
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