Strózecki P, Adamowicz A, Kozłowski M, Włodarczyk Z, Manitius J
Department of Nephrology, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland.
Transplant Proc. 2009 Nov;41(9):3580-4. doi: 10.1016/j.transproceed.2009.06.188.
Increased pulse wave velocity (PWV), an indicator of arterial stiffness, is associated with greater cardiovascular risk among renal transplant recipients. PWV depends on recipient-related factors and, as shown in recent studies, also on donor age. There is a lack of information whether graft-related factors influence arterial function in recipients. Graft cold ischemia time (CIT) significantly influences renal transplant outcomes. It was shown in an experimental model of aortic grafting that increased CIT promoted arteriosclerosis. The aim of the present study was to evaluate the relationship between renal graft CIT and PWV.
Carotid-femoral PWV were measured in 103 cadaveric kidney recipients of mean age 45 +/- 12 years. We analyzed clinical data of recipient and donor ages, genders, body mass index, blood pressure, CIT, delayed graft function, and type of immunosuppressive therapy to compare patients with CIT < 24 (n = 24) versus CIT > or = 24 hours (n = 79).
PWV was lower among patients with shorter CIT (8.3 +/- 1.6 vs 9.2 +/- 2.0 respectively; P < .05). No significant differences were observed between the groups regarding donor and recipient ages, blood pressure, glomerular filtration rate, or immunosuppressive and cardiovascular therapy. A significant positive correlation was noted between PWV and CIT (r = .23; P = .019). Multiple regression analysis demonstrated that recipient age, therapy with cyclosporine, fasting glucose, systolic blood pressure, and CIT were independently associated with PWV.
Long CIT was associated with increased arterial stiffness. Further studies are necessary to understand the cause effect relationship of this finding.
脉搏波速度（PWV）升高是动脉僵硬度的一个指标，与肾移植受者更高的心血管风险相关。PWV取决于受者相关因素，并且如最近的研究所显示，也取决于供体年龄。关于移植物相关因素是否影响受者的动脉功能，目前缺乏相关信息。移植物冷缺血时间（CIT）显著影响肾移植结果。在主动脉移植的实验模型中显示，CIT延长会促进动脉硬化。本研究的目的是评估肾移植移植物CIT与PWV之间的关系。
对103例平均年龄为45±12岁的尸体肾移植受者测量了颈股PWV。我们分析了受者和供体的年龄、性别、体重指数、血压、CIT、移植肾功能延迟及免疫抑制治疗类型等临床数据，以比较CIT<24小时（n = 24）与CIT≥24小时（n = 79）的患者。
CIT较短的患者PWV较低（分别为8.3±1.6与9.2±2.0；P<.05）。两组在供体和受者年龄、血压、肾小球滤过率或免疫抑制及心血管治疗方面未观察到显著差异。PWV与CIT之间存在显著正相关（r = 0.23；P = 0.019）。多元回归分析表明，受者年龄、环孢素治疗、空腹血糖、收缩压和CIT与PWV独立相关。
长CIT与动脉僵硬度增加相关。需要进一步研究以了解这一发现的因果关系。
