Department of Transplant Medicine, Oslo University Hospital, Rikshospitalet, Olso, Norway.
Transplantation. 2013 Mar 15;95(5):733-9. doi: 10.1097/TP.0b013e31827d6312.
Endothelial dysfunction is prevalent in renal transplant recipients, but it is uncertain if there is an association with graft loss or mortality.
Since 1997, we have measured endothelial function noninvasively by forearm laser Doppler flowmetry in several small trials. These tests were pooled for the current analysis. We used Cox proportional hazard models to adjust for patient and graft characteristics. Due to significant heterogeneity between tests conducted before or after day 90 after transplantation, these were examined separately.
In the 175 patients examined after day 90 after transplantation, an endothelial function score below the median predicted graft loss (hazard ratio [HR], 1.85 [1.09-3.16]; P=0.02) and death-censored graft loss (HR, 2.63 [1.18-5.84]; P=0.02) but not all-cause mortality (HR, 1.20 [0.62-2.30]; P=0.58). In 140 patients examined before day 90 after transplantation, no association was found.
Endothelial dysfunction identified more than 90 days after transplantation was associated with renal graft loss.
移植肾受者普遍存在内皮功能障碍，但内皮功能障碍与移植物丢失或死亡率之间是否存在关联尚不确定。
自 1997 年以来，我们通过前臂激光多普勒流量测定法在几项小型试验中对内皮功能进行了非侵入性测量。对这些试验进行了汇总分析。我们使用 Cox 比例风险模型来调整患者和移植物的特征。由于移植后第 90 天前后进行的试验存在显著异质性，因此分别对这些试验进行了检查。
在 175 名在移植后第 90 天以后接受检查的患者中，内皮功能评分低于中位数预示着移植物丢失（风险比 [HR]，1.85 [1.09-3.16]；P=0.02）和死亡相关的移植物丢失（HR，2.63 [1.18-5.84]；P=0.02），但与全因死亡率无关（HR，1.20 [0.62-2.30]；P=0.58）。在 140 名在移植后第 90 天之前接受检查的患者中，未发现相关性。
在移植后 90 天以上发现的内皮功能障碍与肾移植失败有关。
