Division of Cardiology, Department of Medicine, University of California, Irvine, California.
Division of Cardiology, Department of Medicine, Albany Medical Center, Albany, New York.
Transplant Proc. 2021 Jun;53(5):1606-1610. doi: 10.1016/j.transproceed.2021.03.021. Epub 2021 May 7.
Pericardial effusion and tamponade have been recognized as potentially serious complications in patients who have undergone renal transplantation. Our study aims to analyze the association between sirolimus and the development of pericardial effusion in renal transplant recipients.
This is a single-center retrospective study of 585 consecutive patients who underwent renal transplantation between 2005 and 2016. The study included 82 patients (14%) who developed new pericardial effusion after transplantation. Baseline demographics, medical comorbidities, medication use, echocardiographic parameters, and time to occurrence of effusion were assessed. Patients were divided into 2 groups based on timing of effusion development: early onset, ≤4 years after transplantation (51%); and late onset, >4 years after transplantation (49%). We examined the likelihood of immunosuppressant use and timing of effusion development using univariate and multivariate logistic regression analysis.
The mean age of the cohort was 55.1 ± 11.5 years, 58.5% were men, 81.7% were white, and mean time from transplantation to the development of effusion was 4 ± 3.1 years. There were no significant differences between the early and late effusion groups in the demographic characteristics and medical comorbidities. However, sirolimus therapy was more common in the late effusion group. Furthermore, after adjusting for comorbidities, sirolimus use was associated with greater risk for developing late-onset effusion, adjusted odds ratio of 3.58 (95% confidence interval 1.25-10.20, P = .017).
Pericardial effusion is prevalent in renal transplant recipients. In our cohort, treatment with sirolimus was associated with late-onset pericardial effusion. Awareness of pericardial disease in this population is important, and further studies are needed to identify predisposing factors.
心包积液和心包填塞已被认为是肾移植患者潜在的严重并发症。我们的研究旨在分析雷帕霉素与肾移植受者心包积液发生之间的关系。
这是一项对 2005 年至 2016 年间接受肾移植的 585 例连续患者进行的单中心回顾性研究。该研究包括 82 例（14%）患者在移植后出现新发心包积液。评估了基线人口统计学特征、合并症、药物使用、超声心动图参数和积液发生时间。根据积液发生时间将患者分为 2 组：早期（≤4 年）和晚期（>4 年）。使用单变量和多变量逻辑回归分析检查免疫抑制剂使用和积液发生时间的可能性。
队列的平均年龄为 55.1±11.5 岁，58.5%为男性，81.7%为白人，从移植到发生积液的平均时间为 4±3.1 年。早期和晚期积液组在人口统计学特征和合并症方面无显著差异。然而，晚期积液组更常使用雷帕霉素治疗。此外，在调整合并症后，雷帕霉素的使用与晚期发生积液的风险增加相关，调整后的比值比为 3.58（95%置信区间 1.25-10.20，P=0.017）。
心包积液在肾移植受者中很常见。在我们的队列中，雷帕霉素治疗与晚期心包积液有关。了解该人群中心包疾病的重要性，需要进一步研究以确定易患因素。
