Guz Göksel, Karaoğlu Rasim Onur, Kumaş Solak Sezen, Demirgan Ebru Burcu, Demirgan Serdar
Department of Cardiology, Medicana International Hospital, İstanbul, Turkey.
Department of Anesthesiology and Reanimation, SBU Bagcılar Training and Research Hospital, İstanbul, Turkey.
Ann Transplant. 2025 Sep 23;30:e949664. doi: 10.12659/AOT.949664.
BACKGROUND Patients with chronic kidney disease (CKD) have a markedly increased cardiovascular risk, largely due to persistent endothelial dysfunction (ED). Kidney transplantation improves cardiovascular status, but whether transplant type-living donor (LDT) or cadaver donor transplantation (CDT)-differentially affects coronary endothelial function remains unclear. MATERIAL AND METHODS In this prospective observational study, 75 kidney transplant recipients (LDT: n=50; CDT: n=25) and 25 healthy controls (HC) underwent CFVR measurement at baseline (CFVR-1) and 6 months post-transplantation (CFVR-2). Left ventricular ejection fraction (LV-EF), diameters, and NT-proBNP were also assessed. Group comparisons and pre-/post-transplant changes were analyzed. RESULTS Baseline CFVR was higher in HC than in transplant groups (p0.05), but CFVR-1 0.05). A ≥10% EF increase occurred in 36% of patients in each group. CONCLUSIONS Kidney transplantation improves coronary endothelial function and cardiac performance regardless of donor type, though severe baseline CFVR impairment is more common in cadaveric recipients.
慢性肾脏病（CKD）患者心血管风险显著增加，主要归因于持续的内皮功能障碍（ED）。肾移植可改善心血管状况，但活体供肾移植（LDT）或尸体供肾移植（CDT）对冠状动脉内皮功能的影响是否存在差异尚不清楚。
在这项前瞻性观察性研究中，75例肾移植受者（LDT：n = 50；CDT：n = 25）和25名健康对照者（HC）在基线时（CFVR-1）和移植后6个月（CFVR-2）接受了冠状动脉血流储备（CFVR）测量。还评估了左心室射血分数（LV-EF）、直径和N末端脑钠肽前体（NT-proBNP）。进行组间比较以及移植前后变化分析。
HC组的基线CFVR高于移植组（p<0.05），但CFVR-1<CFVR-2在LDT组中显著（p<0.05），而在CDT组中不显著（p>0.05）。每组36%的患者左心室射血分数增加≥10%。
肾移植可改善冠状动脉内皮功能和心脏功能，而与供体类型无关，尽管尸体供肾受者中严重的基线CFVR损害更为常见。
