Accelerated arterial disease in renal transplant recipients.

Abstract

Other mechanisms may be involved: graft anoxia, haeIntroduction mostatic disorders or lipid metabolism, arterial trauma during transplant surgery (clamping and suturing of Along with infectious complications, cardiovascular renal artery) or pre-existing atherosclerotic patches in disease is the predominant cause of morbidity and graft arteries (especially in coronary arteries). mortality in renal transplant recipients [1,2]. The Most attempts at preventing graft arterial disease reasons for this association of arterial disease with have failed. One notable exception has been the prorenal transplantation are complex and have not been tective efficacy of pravastatin (an inhibitor of hydroxyfully elucidated, which makes prevention difficult. methylglutaryl coenzyme A reductase) against To progress in this field, it is essential to make a coronary disease after cardiac transplantation, through clear distinction between the arterial disease affecting a decrease in plasma cholesterol and/or in the cytotoxthe graft itself and the discrete involvement of host icity of natural killer cells [6 ]. Nonetheless, it would arteries, the mechanisms and consequences of these be premature to extend this relative success to the two pathologies being probably different. prevention of allovasculopathy involving arteries other than the coronaries. An essential feature of graft arterial disease is that Arterial disease of the graft it only affects graft arteries and spares the host arteries.