CHANGES OF PLASMA ENDOTHELIN LEVEL IN THE EARLY POST-RENAL TRANSPLANTATION PERIOD

DOI PubMed 2 Citations
  • Masui Noriaki
    Department of Urology, Kitasato University School of Medicine
  • Kumano Kazuo
    Department of Urology, Kitasato University School of Medicine
  • Mashimo Setsuo
    Department of Urology, Kitasato University School of Medicine
  • Endo Tadao
    Department of Urology, Kitasato University School of Medicine

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  • 腎移植後早期における血中エンドセリン動態

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Abstract

Endothelin (ET) has been suggested to be involved in acute graft rejection of kidney transplantation and cyclosporin A (CsA) nephrotoxicity. For clarification of the patho-physiological role of ET in the early post-transplantation period, plasma endothelin-1 (ET-1) was measured by specific radioimmunoassay in renal transplant recipients, patients on maintenance hemodialysis (HD) and healthy volunteers.<br>Twelve transplant recipients were used in this study, 8 of whom were living related subjects and 4 cadaver. Plasma ET-1 and graft function were measured each day, from 1 day prior and 7 days following transplantation and every week up to 5 weeks postoperatively. Plasma ET was measured in 20 other transplant recipients with stable function (serum creatinine≤1.8mg/dl), 20 maintenance HD patients with no residual renal function and 6 healthy volunteers.<br>Mean plasma ET-1 was 13.0±4.5pg/ml in 20 recipients with stable graft function, 21.7±6.5 in 20 HD patients and 1.5±0.4 in healthy volunteers. These differences are statistically significant (p<0.02). Plasma ET-1 showed significant dectrease from 21.8±7.2pg/ml prior to transplantation to 12.8±4.0 when urinary output reached more than 1000ml in living and cadaveric transplantation subjects. All three acute vascular rejections clearly indicated histologically increased plasma ET-1 accompanied by an increase in serum creatinine. A significant positive liner correlation was noted between plasma ET-1 and serum creatinine during the first week following living transplantation. Two patients with clinically and histologically suspected CsA nephrotoxicity showed transient increase in plasma ET-1. These results suggest that ET-1 may be importantly related to the pathogeneiss of post-transplant vascular complications such as CsA nephrotoxicity and vascular rejection.

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