Hyperhomocysteinaemia in heart transplant recipients

The aim of this study was to determine the prevalence of hyperhomocysteinaemiain cardiac transplant recipients, Three groups of subjects werestudied: 27 heart transplant recipients, 14 to 63 months (mean=36.5)after transplantation; 10 patients with moderate chronic renalinsufficiency without clinical evidence of vascular disease;17 apparently healthy individuals. Twenty-five out of 27 transplantedpatients had a coronaroangiography within 6 months of homocysteinemeasurement. Plasma homocysteine was measured both while thesubject was fasting (tO) and 6 h after administration of 0.1g. kg^–1 of methionine (t6). Hyperhomocysteinaemia waspresent in 14127 fasting transplanted patients and after methionineloading. Mean plasma levels of homocysteine at tO were higher(P=0.03) in transplanted heart recipients (15.4 ± 7µmol.l^–1 than in the renal patients (9.9±5µmol.l^–1) despite similar mean plasma creatinin. In eight transplantedpatients with angiographic coronary abnormalities of the cardiacgraft, homocysteinaemia was at tO 17.1 ±9 µmol.l^–1 and at t6 47.8 ±25 µmol. l^–1. In17 transplanted patients with angiographically normal coronaryarteries, plasma homocysteine levels were at tO, 13.2 ±4µmol.l^–1 and at t6, 46.8±25µmol. l^–1. We conclude that hyperhomocysteinaemia is common in transplantedheart recipients, and partly related to renal insufficiency.No correlation was found between hyperhomocysteinaemia and angiographicevidence of coronary atherosclerosis of the graft, but the populationof the study was possibly too small to establish this correlation.