Long Graft Cold Ischemia Time Is Associated With Increased Arterial Stiffness in Renal Transplant Recipients
Abstract
Background
Increased pulse wave velocity (PWV), an indicator of arterial stiffness, is associated with greater cardiovascular risk among renal transplant recipients. PWV depends on recipient-related factors and, as shown in recent studies, also on donor age. There is a lack of information whether graft-related factors influence arterial function in recipients. Graft cold ischemia time (CIT) significantly influences renal transplant outcomes. It was shown in an experimental model of aortic grafting that increased CIT promoted arteriosclerosis. The aim of the present study was to evaluate the relationship between renal graft CIT and PWV.
Methods
Carotid–femoral PWV were measured in 103 cadaveric kidney recipients of mean age 45 ± 12 years. We analyzed clinical data of recipient and donor ages, genders, body mass index, blood pressure, CIT, delayed graft function, and type of immunosuppressive therapy to compare patients with CIT < 24 (n = 24) versus CIT ≥ 24 hours (n = 79).
Results
PWV was lower among patients with shorter CIT (8.3 ± 1.6 vs 9.2 ± 2.0 respectively; P < .05). No significant differences were observed between the groups regarding donor and recipient ages, blood pressure, glomerular filtration rate, or immunosuppressive and cardiovascular therapy. A significant positive correlation was noted between PWV and CIT (r = .23; P = .019). Multiple regression analysis demonstrated that recipient age, therapy with cyclosporine, fasting glucose, systolic blood pressure, and CIT were independently associated with PWV.
Conclusions
Long CIT was associated with increased arterial stiffness. Further studies are necessary to understand the cause effect relationship of this finding.
Department of Nephrology, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
Address reprint requests to Paweł Stróżecki, MD, Nicolaus Copernicus University, Collegium Medicum, ul. Skłodowskiej-Curie 9, Bydgoszcz 85-094, Poland
ABSTRACT