Effect of Kidney Transplant Type on Coronary Endothelial Function in Individuals with Chronic Kidney Disease
Annals of Transplantation, cilt.30, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 30
- Basım Tarihi: 2025
- Doi Numarası: 10.12659/aot.949664
- Dergi Adı: Annals of Transplantation
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
- Anahtar Kelimeler: Coronary Artery Disease, Nephrectomy, Kidney Transplantation, Kidney Failure, Chronic, Thrombocytopenia, Neonatal Alloimmune, Coronary Circulation, Reperfusion Injury, Coronary Circulation, Reperfusion Injury
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: Patients with chronic kidney disease (CKD) have a markedly increased cardiovascular risk, largely due to persistent endothelial dysfunction (ED). Kidney transplantation improves cardiovascular status, but whether transplant type – living donor (LDT) or cadaver donor transplantation (CDT) – differentially affects coronary endothelial function remains unclear. Our aim was to evaluate the impact of transplant type on coronary endothelial function in CKD patients by assessing changes in coronary flow velocity reserve (CFVR) before and after transplantation. Material/Methods: In this prospective observational study, 75 kidney transplant recipients (LDT: n=50; CDT: n=25) and 25 healthy controls (HC) underwent CFVR measurement at baseline (CFVR-1) and 6 months after transplantation (CFVR-2). Left ventricular ejection fraction (LV-EF), diameters, and NT-proBNP were also assessed. Group comparisons and pre-/post-transplant changes were analyzed. Results: Baseline CFVR was higher in HC than in transplant groups (P<0.0001). LDT and CDT had similar CFVR-1 and CFVR-2 (P>0.05), but CFVR-1 <2 was more frequent in CDT (P=0.045). CFVR increased after transplant in both LDT (P=0.0011) and CDT (P=0.0002). LV-EF improved in both groups (P=0.0412 and P=0.0471), with no between-group differences at baseline or follow-up (P>0.05). A ³10% EF increase occurred in 36% of patients in each group. Conclusions: Kidney transplantation improves coronary endothelial function and cardiac performance regardless of donor type, although severe baseline CFVR impairment is more common in cadaveric recipients.