ABSTRACT
To discuss the risk factors of developing cardiovascular disease [CVD] after the kidney transplantation. Retrospective analysis on the data of 1106 patients who had been underwent kidney allotransplantation in People's Hospital of Zhengzhou from July, 2010 to Dec, 2014 and conformed to the inclusion criteria was taken. Cox proportional hazard model was used to analyze the risk factors of developing CVD after the kidney transplantation. 7 days, 1 month, 3 months, 6 months and 12 months before and after the operation, the data collection and following-up visits were respectively arranged. 12 months after the operation, the following-up visits were arranged once a half year until the end of March, 2014. 216 [19.5%] patients developed CVD after the kidney transplantation. Among them, 47 [4.2%] patients developed CVD within the first three months after the operation, which accounted for 26.8% in the CVD patients; 125 [11.3%] patients developed CVD within the first one year after the operation, which accounted for 47.9% in the CVD patients. 51 [4.6%] patients died after the operation. Among them, 19 [2.7%] patients died of CVD, which accounted for 37.3% in the whole died patients. Multiple factors analysis revealed that the following were the risk factors to develop CVD after the kidney transplantation: The age of receptors was greater than 50 [OR=2.39, 95%CI 1.15-3.60]; The receptors had diabetes before the surgery [OR=3.18, 95%CI 1.56-6.42]; The receptors had CVD medical history before the surgery [OR=3.85, 95%CI 2.15-7.54]; The primary diseases of receptors were diabetic nephropathy [DN] [OR=2.12, 95%CI 1.14-3.98]; The preoperative dialysis time was greater than 12 months[OR=1.27, 95%CI 0.98-1.38]; The postoperative serum creatinine of the receptors was greater than 200 micro mol/L [OR=2.78, 95%CI 1.35[tilde]4.53]; The delayed graft failure [DGF] occurred [OR=1.24, 95%CI 1.02[tilde]1.42]; Acute rejection appeared[AR][OR=2.98, 95%CI 1.56[tilde]5.72]; Renal allograft dysfunction appeared [OR=4.86, 95%CI 3.15[tilde]7.78]. The morbidity of CVD is high after the kidney transplantation and the risk factors are diversified. That revising or excluding relevant risk factors may lower the morbidity of developing CVD and is in favor of the long-term survival for the transplanted kidney
ABSTRACT
Objective: To explore clinical effect of treating acute coronary syndrome [ACS] of renal transplant recipients with percutaneous coronary intervention and its safety
Methods: Forty two renal transplant recipients who were diagnosed with acute coronary syndrome and received percutaneous coronary intervention [PCI] in our hospital were selected. Serum creatinine [Cr] and glomerular filtration rate [GFR] were compared before surgery, 48 [tilde] 72 hour after surgery and one year after surgery. All patients were followed up
Results: All patients successfully completed PCI. Contrast-induced nephropathy was not found after surgery. Cr and GFR 48 [tilde] 72 hour after surgery and one year after surgery had no significant differences with that before surgery [P>0.05]. The follow up lasted for [61.2 +/- 32.2] months averagely. Of 42 cases, 4 cases died, 6 cases were found with nonfatal myocardial infarction, 4 cases were observed with repeat revascularization and 12 cases had accumulative major adverse cardiovascular events [MACE]
Conclusion: PCI is proved to be effective in treating renal transplant recipients; no severe complications are found and renal function recovers well after treatment
ABSTRACT
Objective To explore the characteristics and effects of interventional therapy of transplant renal artery rupture of donation after citizens death (DCD).Method Among 28 cases of DCD renal transplantations (from February 2012 to December 2013),the transplant renal artery rupture occurred in 4 cases.Vascular complications were treated with the guide wires to place stents in the pseudoaneurysms or bleeding period.Result Pseudoaneurysms occurred in 2 cases,and they were successfully discharged after interventional treatment.In the rest two patients,the artery residual ruptured and bled after the nephrectomy,and they recovered after interventional treatment to stop bleeding.Conclusion For kidney transplant recipients,the DCD postoperative infection is risky.Some transplant kidneys have local infection and erosion of renal artery,which causes arterial hemorrhage.The interventional treatment of transplant renal artery pseudoaneurysms and rupture bleeding has the advantages of small trauma and instant effect,and can be used as an alternative treatment of open surgery.