The Role of Immunosuppression on Cardiac Functions of Kidney Transplant Recipients

U. Cakir, O. Cavdaroglu, T. Erturk, E. Gurluler, A. Gurkan, I. Berber.

Transplant Center, Acibadem University, Istanbul, Turkey.

Meeting: 2015 American Transplant Congress

Abstract number: A175

Keywords: Echocardiography, Kidney transplantation

Session Information

Session Name: Poster Session A: Kidney: Cardiovascular and Metabolic

Session Type: Poster Session

Date: Saturday, May 2, 2015

Session Time: 5:30pm-7:30pm

Presentation Time: 5:30pm-7:30pm

Location: Exhibit Hall E

Cardiac disorders are associated with high morbidity and mortality in end-stage renal disease (ESRD).Kidney transplantation is known to increase the survival of dialysis patients by ameloriating both systolic and diastolic functions.

We aimed to evaluate the role of immunosuppressive (IS) drug regimens on cardiac functions of kidney transplant recipients (KTRs) one year after the transplantation.We prospectively evaluated 100 KTRs immediately before and one year after the operation, using tissue Doppler echocardiography.A triple IS therapy including Tacrolimus, Mycophenolate Mofetil (MMF) and Prednisolone was started for all patients.After 3-6 months Tacrolimus dose was lowered in order to achieve target serum levels of 3-7 ng/mL in both groups.MMF was switched to Everolimus with target levels of 4-6 ng/mL, in Group I(N=50) while Group II(N=50) continued with MPA.

No differences in age, gender, dialysis duration, number of HLA mismatches existed between the groups.The prevalence of diabetic or hypertensive nephropathy as the etiology of ESRD was similar.Blood pressure was strictly controlled.Number of acute rejection episodes was not different in both groups and no graft loss was observed in either group.Improvement in cardiac parameters including ejection fraction (EF), left ventricle diastolic diameter (LVDD), posterior wall thickness (LVPW), left atrium (LA), pulmonary artery systolic pressure (PASP), left ventricle hypertrophy (LVH) was significant before and one year after transplantation.Interestingly, when compared to Group II, ameloriation of all of the parameters mentioned above was even better in Group I patients.

[table1] Echocardiographic findings before and one year after transplantation (N:100)
Parameter	Pretransplantation	1 year after transplantation	p
EF (%)	44.2±7.8	56.4±3.8	0.001*
LVDD (mm)	53.1±2.1	47.2±4.2	0.002*
LVPW (mm)	14.7±3.2	11.5±2.2	0.03*
LA (mm)	48.1±4.2	37.1±2.5	0.02*
PASP (mmHg)	47.9±12.7	36.4±11.7	0.002*
LVH (%)	46/100 (46%)	41/100 (41%)	0.045*

*p<0.05: Statistically significant

[table2] Echocardiographic findings in each group, one year after transplantation
Parameter	Group 1 (Everolimus, N=50)	Group 2 (MPA=50)	p
EF (%)	58.2±3.4	53.±3.2	0.002*
LVDD (mm)	43.2±2.1	48.4±3.9	0.002*
LVPW (mm)	9.9±3.2	12.5±2.4	0.03*
LA (mm)	35.1±3.6	38.9±2.6	0.02*
PASP (mmHg)	27.4±4.8	40.4±4.7	0.001*
LVH (%)	18/50 (36%)	22/50 (44%)	0.035*

*p<0.05: Statistically significant

Better ameloriation of cardiovascular functions with everolimus may favor the choice of this drug in kidney transplant recipients.

To cite this abstract in AMA style:

Cakir U, Cavdaroglu O, Erturk T, Gurluler E, Gurkan A, Berber I. The Role of Immunosuppression on Cardiac Functions of Kidney Transplant Recipients [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/the-role-of-immunosuppression-on-cardiac-functions-of-kidney-transplant-recipients/. Accessed November 23, 2024.

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