Vascular Damage and Kidney Transplant Outcomes: An Unfriendly and Harmful Link

Hernández, Domingo; Triñanes, Javier; Armas, Ana María; Ruiz-Esteban, Pedro; Alonso-Titos, Juana; Duarte, Ana; González‐Molina, Miguel; Palma, Eulalia; Salido, Eduardo; Torres, Armando

doi:10.1016/j.amjms.2017.01.004

Cited by 5 publications

(2 citation statements)

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“…As a result of the increasing number of ECD and of the aging of both donor and recipient population, atherosclerosis of the vascular axis of the graft and of the recipient is becoming a serious challenge in the field of organ transplantation (20)(21)(22)(23).…”

Section: Discussionmentioning

confidence: 99%

Iloprost in Acute Post-kidney Transplant Atheroembolism: A Case Report of Two Successful Treatments

et al. 2020

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Cholesterol embolization (CE) is a rare and alarming post-transplant complication, responsible for primary non-function (PNF) or delayed graft function (DGF). Its incidence is expected to rise due to increasingly old donors and recipients and the extended criteria for donation. Therapy with statins and steroids has not been shown to be effective, while agonism of prostaglandin I 2 has been reported to be useful in systemic CE. We report two cases of acute post-transplant CE in which intravenous iloprost (0.05 mg/kg/day) was added to standard statin and steroid therapy. In the first instance, CE was due to embolization from the kidney artery resulting in embolization of the small vessels; after a long DGF and 15 days of iloprost therapy, renal function recovered. The second instance is a case of embolization from the iliac artery of the recipient, where CE manifested as a partial renal infarction. After 5 days of iloprost administration, creatinine levels improved. Iloprost acts on vasodilation and on different inflammatory pathways, improving the anti-inflammatory profile. Post-transplant CE is difficult to diagnose and, if not treated, can lead to loss of function. Iloprost added to standard therapy could be beneficial in accelerating renal function recovery immediately after transplant.

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Section: Discussionmentioning

confidence: 99%

Iloprost in Acute Post-kidney Transplant Atheroembolism: A Case Report of Two Successful Treatments

et al. 2020

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“…1,2 KT recipients frequently have both traditional and nontraditional cardiovascular risk factors, leading to increased cardiovascular disease (CVD), including peripheral vascular disease (PVD). 3 The PVD rate posttransplantation is high, and the number of older and diabetic patients who receive a KT is increasing markedly worldwide. These patients, though, often have PVD, which is associated with worse patient and allograft survival than those who do not have PVD.…”

Section: Introductionmentioning

confidence: 99%

Peripheral Vascular Disease and Kidney Transplant Outcomes: Rethinking an Important Ongoing Complication

et al. 2020

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Peripheral vascular disease (PVD) is highly prevalent in patients on the waiting list for kidney transplantation (KT) and after transplantation and is associated with impaired transplant outcomes. Multiple traditional and nontraditional risk factors, as well as uremia-and transplant-related factors, affect 2 processes that can coexist, atherosclerosis and arteriosclerosis, leading to PVD. Some pathogenic mechanisms, such as inflammation-related endothelial dysfunction, mineral metabolism disorders, lipid alterations, or diabetic status, may contribute to the development and progression of PVD. Early detection of PVD before and after KT, better understanding of the mechanisms of vascular damage, and application of suitable therapeutic approaches could all minimize the impact of PVD on transplant outcomes. This review focuses on the following issues: (1) definition, epidemiological data, diagnosis, risk factors, and pathogenic mechanisms in KT candidates and recipients; (2) adverse clinical consequences and outcomes; and (3) classical and new therapeutic approaches.

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Everolimus in kidney transplant recipients at high cardiovascular risk: a narrative review

et al. 2019

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Vascular Damage and Kidney Transplant Outcomes: An Unfriendly and Harmful Link

Cited by 5 publications

References 126 publications

Iloprost in Acute Post-kidney Transplant Atheroembolism: A Case Report of Two Successful Treatments

Iloprost in Acute Post-kidney Transplant Atheroembolism: A Case Report of Two Successful Treatments

Peripheral Vascular Disease and Kidney Transplant Outcomes: Rethinking an Important Ongoing Complication

Everolimus in kidney transplant recipients at high cardiovascular risk: a narrative review

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