Risk of post‐transplant cardiovascular events in kidney transplant recipients with preexisting aortoiliac stenosis

Babakry, Shabnam; Rijkse, Elsaline; Roodnat, Joke I.; Bijdevaate, Diederik; IJzermans, Jan N.M.; Minnee, Robert C.

doi:10.1111/ctr.14515

Cited by 3 publications

(1 citation statement)

References 56 publications

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“…Existen diversas complicaciones que se presentan posterior a la cirugía, algunas de aquellas se presentan dentro de los tres primeros meses o seis y algunas suelen presentarse al año de haber sido trasplantado (7). Como complicaciones tempranas más frecuentes tenemos a las infecciones, enfermedades cardio vasculares, alteraciones neurológicas y en el metabolismo y en este punto es necesario resaltar que los factores de riesgo que hayan estado presente en el receptor o donador antes del trasplante son aquellos que aceleraran cualquiera de estos eventos, siendo un proceso desfavorable tanto para el receptor como para el injerto (8).…”

Section: Introductionunclassified

Complicaciones tempranas postrasplante renal asociada a la sobrevida del paciente.

Cumbe-Barzola,

Bueno-Castro

2023

MQRInvestigar

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La enfermedad renal en etapa terminal tiene como mejor método el trasplante dando una mejor calidad de vida al paciente, pero para esto es necesario aclarar cuáles son las complicaciones tempranas que este puede presentar postrasplante puesto que es necesario actuar de manera oportuna para evitar el fallo del injerto o incluso a la muerte del receptor, el objetivo del presente trabajo es describir las complicaciones tempranas del postrasplante renal, relacionadas a la sobrevida del paciente, se han podido observar complicaciones relacionadas también al uso de los inmunosupresores causando daños neurológicos y dando paso a infecciones, otras complicaciones también están relacionadas al sistema cardiovascular, gastrointestinal y en muy raras ocasiones se han descrito afectación a la cavidad bucal. Para la presente revisión bibliográfica se utilizó la biblioteca virtual de la universidad católica de cuenca en donde se tuvo acceso a la base de datos como pubmed, web of scince, scopus y se utilizó artículos científicos sin restricción de idioma y con cinco años de antigüedad que entren dentro del Q1 a Q4 Se concluyo que las complicaciones más frecuentes que pudimos observar en la investigación fueron las infecciosas y estas presentaron tener estrecha relación con la pérdida o falla del injerto e incluso con el fallecimiento del paciente en aproximadamente un 50% dependiendo cual sea el agente patógeno que haya infectado al injerto

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Section: Introductionunclassified

Complicaciones tempranas postrasplante renal asociada a la sobrevida del paciente.

Cumbe-Barzola,

Bueno-Castro

2023

MQRInvestigar

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Safety and efficacy of kidney transplantation in patients with aortoiliac stenosis: a retrospective cohort study

Fang,

Hamm,

den Hartog

et al. 2023

International Journal of Surgery

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Background: The impact of aortoiliac occlusive disease on kidney transplantation remains unclear. This study aims to investigate the clinical outcomes of kidney transplant patients with aortoiliac atherosclerotic stenosis. Methods: Retrospective data from our transplant center were used to identify patients undergoing kidney transplantation between January 2010 and December 2020. Aortoiliac atherosclerotic stenosis was screened and stratified by the Trans-Atlantic Inter-Society Consensus (TASC) II classification. The primary outcome was patient survival. Secondary outcomes were 90-day mortality, death-censored graft survival, graft function and arterial complications. Propensity score matching was used to match all patients in the stenosis group with patients without stenosis sharing similar characteristics. Results: The analysis included 655 patients, 524 without stenosis, and 131 with aortoiliac stenosis (95 with TASC A/B stenosis, 36 with TASC C/D stenosis). Recipient age (median [IQR], 66 [60-70] vs. 66 [59-71] years; P=0.47), gender (male: 87 [66%] vs. 355 [68%], P=0.85), and comorbidities were comparable between the stenosis and no-stenosis groups. Forty-six (35%) patients with stenosis were symptomatic. Patient survival was significantly lower in the stenosis group compared to the no-stenosis group (TASC A/B: 30.6% vs. no-stenosis: 44.1%, P=0.013; TASC C/D: 11.4% vs. no-stenosis: 44.1%, P<0.001). The incidence rates of artery dissection, lower extremity ischemia and acute thrombosis were significantly higher in the stenosis group (P<0.001). However, death-censored graft survival (TASC A/B: 73.6% vs. no-stenosis: 72.9%, P=0.62; TASC C/D: 58.1% vs. no-stenosis: 72.9%, P=0.16) and graft function were comparable between the groups. Conclusions: Aortoiliac atherosclerotic stenosis significantly impacts patient survival but not graft survival. Our analyses suggest that patients with TASC A/B stenosis have prolonged survival and enhanced quality of life through kidney transplantation. However, for patients with TASC C/D stenosis, kidney transplantation improves quality of life without bringing survival benefits.

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Risk of post‐transplant cardiovascular events in kidney transplant recipients with preexisting aortoiliac stenosis

Babakry

Rijkse

Roodnat

et al. 2021

Clinical Transplantation

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Prediction of the risk of cardiovascular events (CVE's) is important to optimize outcomes after kidney transplantation. Aortoiliac stenosis is frequently observed during pre-transplant screening. We hypothesized that these patients are at higher risk of post-transplant CVE's due to the joint underlying atherosclerotic disease. Therefore, we aimed to assess whether aortoiliac stenosis was associated with post-transplant CVE's. This retrospective, single-center cohort study included adult kidney transplant recipients, transplanted between 2000 and 2016, with contrast-enhanced imaging available. Aortoiliac stenosis was classified according to the Trans-Atlantic Inter-Society Consensus (TASC) II classification and was defined as significant in case of ≥50% lumen narrowing. The primary outcome was CVE-free survival. Eighty-nine of 367 patients had significant aortoiliac stenosis and were found to have worse CVEfree survival (median CVE-free survival: stenosis 4.5 years (95% confidence interval (CI) 2.8-6.2), controls 8.9 years (95% CI 6.8-11.0); log-rank test P < .001). TASC II C and D lesions were independent risk factors for a post-transplant CVE with a hazard ratio of 2.15 (95% CI 1.05-4.38) and 6.56 (95% CI 2.74-15.70), respectively. Thus, kidney transplant recipients with TASC II C and D aortoiliac stenosis require extensive cardiovascular risk management pre-, peri,-and post-transplantation.

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Risk of post‐transplant cardiovascular events in kidney transplant recipients with preexisting aortoiliac stenosis

Cited by 3 publications

References 56 publications

Complicaciones tempranas postrasplante renal asociada a la sobrevida del paciente.

Complicaciones tempranas postrasplante renal asociada a la sobrevida del paciente.

Safety and efficacy of kidney transplantation in patients with aortoiliac stenosis: a retrospective cohort study

Risk of post‐transplant cardiovascular events in kidney transplant recipients with preexisting aortoiliac stenosis

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