RESUMEN
BACKGROUND Recent studies have demonstrated that statins have anti-inflammatory and immunomodulatory properties, which could be considered beneficial in kidney transplantations. This study assesses the anti-inflammatory effect of atorvastatin on the kidney grafts of living donor transplants. MATERIAL AND METHODS In a randomized clinical trial, kidney donors were divided into 2 groups. The study group constituted 24 donors who received 40 mg atorvastatin, and 24 donors who received a placebo control, 4 weeks prior to transplantation. Serum C-reactive protein (CRP) levels were measured before and after atorvastatin administration. CRP and renal function of kidney recipients were measured at baseline and 1, 6, and 24 hours after transplantation. RESULTS After 4 weeks of treatment, the CRP level was 5.62±3.82 mg/dL in the control group and 3.27±0.62 mg/dL in the study group (P=0.007). Upon reperfusion, CRP levels in recipients at 1 hour were, 5.8±3.9 and 3.8±1.0 mg/dL, respectively (P=0.04). Twenty-four hours after the kidney transplantations, serum creatinine levels were 2.5±1.5 mg/dL in the study group and 3.7±2.4 mg/dL in the control group (P=0.04). CONCLUSIONS Our study suggests that the use of atorvastatin prior to allograft procurement of kidney transplant, reduces the acute kidney inflammatory burden profile, and promotes an improved kidney function recovery following transplantation.
Asunto(s)
Antiinflamatorios/uso terapéutico , Atorvastatina/uso terapéutico , Inflamación/tratamiento farmacológico , Trasplante de Riñón/métodos , Donadores Vivos , Adulto , Proteína C-Reactiva/metabolismo , Femenino , Supervivencia de Injerto , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
BACKGROUND The incidence of surgical complications after kidney transplantation ranges from 10-25%. The purpose of this study was to evaluate if the application of fibrin glue as a preventive agent reduces surgical morbidity after a living-related-donor kidney transplantation. MATERIAL AND METHODS A controlled clinical trial involving 78 recipients randomly assigned to receive fibrin glue and 79 in the control group without the application of fibrin glue. Patients were followed for six months after surgery. RESULTS The average ages were 24.8±9.4 and 27.4±11.3 years in the control and study groups, respectively (p=0.11). Individual morbidities, such as urologic, lymphatic, vascular, and wound complications, were not statistically different between groups; however, the total number of surgical complications observed were in five patients in the study group and 16 patients in the control group. This difference was statistically significant (p<0.01, relative risk 0.44, 95% CI 0.20-0.97). There was no mortality or adverse reaction to fibrin glue. One kidney graft was lost because of uncontrollable bleeding secondary to tearing of the renal capsule. The incidence of early medical complications was similar between groups. CONCLUSIONS Applications of the biological adhesive reduced the incidence of surgical complications.