An experimental study of platelet aggregation was performed in 22 male Landrace x Large-White crossbred pigs treated with propofol at different doses, to compare the results of optical aggregometry with those of the PFA-100 (Dade Int., Miami, FL, USA), a new platelet function analyzer. Platelet aggregation was analyzed in basal blood samples by both methods, after which the pigs were divided into three groups: G1, anaesthetic induction with propofol (2 mg/kg intravenously (i.v.)); G2, anaesthetic induction with propofol (2 mg/kg i.v.), followed by a second dose of 1.5 mg/kg; and G3, anaesthetic induction with propofol (2 mg/kg i.v.), followed by 1 h of continuous i.v. infusion at 13 mg/kg/h. Four minutes after propofol injection, blood samples were again taken from each group and studied by both methods. In groups G2 and G3, both methods showed reduced platelet aggregation, while in group G1 neither evidenced an anti-aggregating effect of propofol. Under our experimental conditions: (1) the propofol effect on platelet aggregation depends on the plasma concentration; (2) the results obtained with the two methods are comparable; (3) PFA-100 may provide an alternative to optical aggregometry for detecting the effects of anaesthetic agents ex vivo.

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BACKGROUND AND AIMS The incidence of chronic kidney disease (CKD) in patients with lung transplantation (LTx) has increased over the last decades. Progression factors recognized in the development of CKD are: older age and comorbidity of recipients, immunosuppressive (IS) toxicity and longer survival. There is a lack of specific information about other risk factors or specific preventive management of CKD. METHOD Retrospective, single-centre study including all patients with LTx on Nephrology outpatient clinic among 2007 and 2020. Demographic, comorbidity and intercurrent events, renal function impairment, proteinuria and IS treatment were analyzed. We defined composite renal event (MARE) as renal replacement therapy (RRT), death or doubling serum creatinine. RESULTS A total of 69 LTx receptors (79.4% double LTx) were followed in a dedicated outpatient nephrology clinic. A total of 52.2% male, mean age at LTx 48.3 years (SD 16.6). Etiology of lung disease: cystic fibrosis (30.4%), obstructive lung disease or emphysema (33.3%) and interstitial disease (30.4%). After LTx, as complications, infection was the most frequent event (89.7%) and 49.3% presented neoplasic illness. The mean time from LTx until first nephrologist evaluation was 6.6 years (2 months–19.9 years) and main comorbidities were: hypertension (81.2%), diabetes mellitus (52.2%), dyslipidemia (50.7%), 60.3% former smokers and 26.1% had suffer from a previous CV event. After 1 year of LTx, mean eGFR decreased to 49.8 mL/min, which means that only in the first year after LTx there is a loss of ∼50% of mean kidney function. Factor associated with impaired kidney function at the first year after LTxw was cystic fibrosis (higher percentage in the rapid progression group). At first evaluation by Nephrology, the mean eGFR was 30.9 mL/min (SD 15.3), with a CKD distribution: 39.4% CKD 3; 45.5% CKD 4 and 12.1% CKD 5 (<15). Clinical study and biopsy define CKD etiologies: CNI toxicity (68.1%) thrombotic microangiopathy (11.6%), tubular (10.1%), vascular (7.3%) and glomerulopathies (2.9%). A total of 88.4% patients reached MARE at the end of the study. A total of 24 patients required RRT (mean time since LTx 9.2 years) and thereafter, 10 received a kidney transplantation (KTx). In Dyalisis group, a higher mortality was observed versus no dialysis group (24 versus 2.2%), a higher percentage of vascular origin disease with a further deterioration of eGFR at the time of referral to Nephrology. At the end of follow-up, 15 patients died (14 were in RRT), 5 continued on HD and 5 with a functional KTx, and 44 patients were still without RRT. CONCLUSION

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