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Slow Progression of Aortic Calcification Is a Potential Benefit of Pre-emptive Kidney Transplantation

H Mursawa1, S Hatakeyama1, H Yamamoto1

  • 1Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.

Transplantation Proceedings
|February 7, 2018
PubMed

Insights

Pre-emptive kidney transplantation (PKT) slows aortic calcification progression compared to dialysis. While not significantly impacting graft or cardiovascular survival, this slower progression may reduce long-term cardiovascular events in PKT recipients.

Area of Science:

  • Nephrology
  • Cardiology
  • Transplantation Medicine

Background:

  • Pre-emptive kidney transplantation (PKT) is hypothesized to improve outcomes over standard transplantation.
  • Aortic calcification is linked to renal dysfunction and cardiovascular events, but its role in PKT is understudied.
  • Understanding PKT's effect on aortic calcification is crucial for assessing its long-term benefits.

Purpose of the Study:

  • To evaluate if PKT offers protection against aortic calcification progression.
  • To compare renal function, graft survival, and cardiovascular event-free survival between PKT and pretransplant dialysis groups.
  • To determine the association between aortic calcification and cardiovascular events post-transplantation.

Main Methods:

  • Retrospective analysis of 100 adult kidney transplant recipients (19 PKT, 81 pretransplant dialysis).
  • Comparison of pre- and post-transplant aortic calcification index (ACI) and estimated glomerular filtration rate (eGFR).
  • Assessment of graft and cardiovascular event-free survivals.

Main Results:

  • PKT recipients had significantly lower preoperative aortic calcification index (ACI).
  • The rate of ACI progression was significantly lower in the PKT group.
  • No significant differences were observed in postoperative eGFR, graft survival, or cardiovascular event-free survival between groups; however, higher ACI correlated with poorer cardiovascular outcomes.

Conclusions:

  • PKT demonstrates a benefit by slowing the progression of aortic calcification post-transplantation.
  • While immediate graft and cardiovascular survival differences were not significant, reduced aortic calcification progression in PKT patients suggests potential for decreased long-term cardiovascular events.
  • Further long-term studies are warranted to confirm the cardiovascular benefits of PKT.
Abstract

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