Jarmi Tambi, Spaulding Aaron C, Jebrini Abdullah, Sella David M, Alexander Lauren F, Nussbaum Samuel, Shoukry Mira, White Launia, Wadei Hani M, Farres Houssam
Department of Transplant, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
Division of Health Delivery Research, Mayo Clinic Florida, Jacksonville, USA.
World J Surg. 2022 Oct;46(10):2468-2475. doi: 10.1007/s00268-022-06665-z. Epub 2022 Jul 19.
Abdominal arterial calcification (AAC) is common among candidates for kidney transplant. The aim of this study is to correlate AAC score value with post-kidney transplant outcomes.
We modified the coronary calcium score by changing the intake data points and used it to quantitate the AAC. We conducted a retrospective clinical study of all adult patients who were transplanted at our center, between 2010 and 2013, and had abdominal computed tomography scan done before transplantation. Outcomes included mortality, pulse pressure (PP) measured by 24 h ambulatory blood pressure monitoring system, and kidney allograft function measured by iothalamate clearance.
For each 1000 increase of AAC score value, there is an associated 1.05 increase in the risk of death (95% CI 1.02, 1.08) (p < 0.001). Overall median AAC value for all patients was 1784; Kaplan-Meier curve showed reduced survival of all-cause mortality for patients with AAC score value above median and reduced survival among patients with cardiac related mortality. The iothalamate clearance was lower among patients with total AAC score value above the median. Patients with abnormal PP (< 40 or > 60 mmHg) had an elevated median AAC score value at 4319.3 (IQR 1210.4, 11097.1) compared to patients with normal PP with AAC score value at 595.9 (IQR 9.9, 2959.9) (p < 0.001).
We showed an association of AAC with patients' survival and kidney allograft function after kidney transplant. The AAC score value could be used as a risk stratification when patients are considered for kidney transplant.
腹部动脉钙化（AAC）在肾移植候选者中很常见。本研究的目的是将AAC评分值与肾移植术后结局相关联。
我们通过改变输入数据点对冠状动脉钙化评分进行了修改，并将其用于定量AAC。我们对2010年至2013年间在本中心接受移植且移植前进行了腹部计算机断层扫描的所有成年患者进行了一项回顾性临床研究。结局包括死亡率、通过24小时动态血压监测系统测量的脉压（PP）以及通过碘他拉酸盐清除率测量的同种异体肾移植功能。
AAC评分值每增加1000，死亡风险相应增加1.05（95%可信区间1.02，1.08）（p<0.001）。所有患者的总体中位AAC值为1784；Kaplan-Meier曲线显示，AAC评分值高于中位数的患者全因死亡率生存率降低，心脏相关死亡率患者的生存率也降低。总AAC评分值高于中位数的患者碘他拉酸盐清除率较低。PP异常（<40或>60 mmHg）的患者中位AAC评分值为4319.3（四分位间距1210.4，11097.1），高于PP正常且AAC评分值为595.9（四分位间距9.9，2959.9）的患者（p<0.001）。
我们显示了AAC与肾移植后患者生存率及同种异体肾移植功能之间的关联。在考虑患者进行肾移植时，AAC评分值可作为一种风险分层方法。
