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Aorto-Iliac Artery Calcification and Graft Outcomes in Kidney Transplant Recipients

Stan Benjamens1,2, Saleh Z Alghamdi1, Elsaline Rijkse3

  • 1Department of Surgery, Division of Transplant Surgery, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands.

Journal of Clinical Medicine
|January 22, 2021
PubMed

Insights

Pre-transplant aorto-iliac calcification in kidney transplant recipients is linked to overall graft failure and death with a functioning graft, but not graft function decline. Further prevention efforts are crucial.

Area of Science:

  • Nephrology
  • Vascular Surgery
  • Transplantation Medicine

Background:

  • Vascular calcification is linked to poor outcomes in kidney transplant recipients.
  • The impact of aorto-iliac calcification on kidney graft outcomes requires further investigation.

Purpose of the Study:

  • To assess the association between pre-transplant aorto-iliac calcification and kidney graft outcomes.
  • To determine the clinical impact of recipient aorto-iliac calcification on graft function and survival.

Main Methods:

  • Dual-centre cohort study including 547 kidney transplant recipients (2005-2018).
  • Aorto-iliac calcification measured using non-contrast enhanced computed tomography (CT)-imaging.
  • Analysis included univariate and multivariable regression models, with a median follow-up of 3.1 years.

Main Results:

  • Pre-transplant aorto-iliac calcification score (CaScore) was inversely associated with one-year estimated-glomerular filtration rate (eGFR) in univariate analysis (p < 0.0001).
  • High CaScore was associated with increased overall graft failure (p = 0.004) and death with a functioning graft (p = 0.002).
  • No significant association was found between high CaScore and death-censored graft failure or graft function decline.

Conclusions:

  • Pre-transplant aorto-iliac calcification is associated with overall graft failure and death with a functioning graft in kidney transplant recipients.
  • Transplantation in patients with high calcification scores does not lead to earlier transplant function decline or worse death-censored graft survival.
  • Continued focus on preventing death with a functioning graft is essential in this patient population.

Keywords:
aortagraft failuregraft functiongraft function declineiliac arterykidney transplantationvascular calcification

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