The influence of pretransplant lipoprotein abnormalities on the early results of renal transplantation

Abstract. Lipoprotein patterns were investigated before and after renal transplantation in a prospective study including 151 patients. Kidney graft losses during the first 6 months were associated with higher total cholesterol ( P = 0.03), LDL cholesterol ( P = 0.003) and LDL triglyceride levels ( P = 0.01) before transplantation. Patients with serum cholesterol ±6.9 mmol l^-1 before transplantation had more acute rejections (1.7 vs. 0.9), a worse graft function and more vascular intimal hyperplasia and glomerular mesangial changes in transplant biopsies at 6 months. Patients with serum creatinine levels exceeding 160 μmol l^-1 at 6 months had more severe lipid disorders already before transplantation.
Serum creatinine at 6 months was influenced by the number of acute rejection episodes ( P = 0.0001) and the age of the donor ( P = 0.009) while the number of acute rejections was found to be related to pretrans plant total cholesterol levels ( P = 0.0086) and the age of the recipient ( P = 0.025).
In conclusion, pretransplant lipoprotein disturbances have an impact on the early outcome of renal transplantation. Since there is a progresssion of hyperlipidaemia following transplantation, this may have an influence also on the cardiovascular morbidity and late graft dysfunction.