The Impact of Kidney/Pancreas Transplantation on Peripheral Arterial Disease

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Autori principali:	Richard J. Knight, Yan Ye, Edward A. Graviss, Duc T. Nguyen, Zsolt Garami, Stephanie G. Yi, Mark Hobeika, Charudatta S. Bavare, Archana R. Sadhu, A. Osama Gaber
Natura:	Artículo Open Access
Pubblicazione:	Wiley 2024
Soggetti:	Clinical Transplantation
Accesso online:	Acceder al recurso
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author	Richard J. Knight Yan Ye Edward A. Graviss Duc T. Nguyen Zsolt Garami Stephanie G. Yi Mark Hobeika Charudatta S. Bavare Archana R. Sadhu A. Osama Gaber
author_facet	Richard J. Knight Yan Ye Edward A. Graviss Duc T. Nguyen Zsolt Garami Stephanie G. Yi Mark Hobeika Charudatta S. Bavare Archana R. Sadhu A. Osama Gaber Richard J. Knight Yan Ye Edward A. Graviss Duc T. Nguyen Zsolt Garami Stephanie G. Yi Mark Hobeika Charudatta S. Bavare Archana R. Sadhu A. Osama Gaber
collection	Wiley Open Access
contents	The Impact of Kidney/Pancreas Transplantation on Peripheral Arterial Disease Richard J. Knight Yan Ye Edward A. Graviss Duc T. Nguyen Zsolt Garami Stephanie G. Yi Mark Hobeika Charudatta S. Bavare Archana R. Sadhu A. Osama Gaber Clinical Transplantation ABSTRACTIntroductionIt is unclear whether kidney/pancreas (KP) transplantation will prevent the progression of peripheral arterial disease (PAD) in patients with insulin dependent diabetes (IDDM) and end‐stage renal disease. We sought to determine the pre‐ and posttransplant prevalence of symptomatic PAD and changes in carotid artery intima‐media thickness (IMT) in KP recipients.MethodsIn this single center study, outcomes were compared between KP recipients with and without a history of PAD. A subset of recipients underwent pre‐ and posttransplant IMT measurements.ResultsAmong the study group (N = 107), 18 (17%) recipients admitted to a pretransplant history of symptomatic PAD, comprised 11 foot infections and 7 amputations (5 minor and 2 major). Baseline characteristics of age, gender, race, years of diabetes, dialysis history, smoking history, years of hypertension, and history of coronary artery disease (CAD) were equivalent between PAD and non‐PAD cohorts. At a median follow‐up of 60 months (IQR: 28, 110), 16 (15%) KP recipients had suffered a PAD event. In multivariate analysis, a pretransplant history of PAD (hazard ratio [HR] 9.66, p < 0.001) and CAD (HR 3.33, p = 0.04) were independent predictors of posttransplant PAD events. Among a subset of 20 recipients (3 with PAD), mean IMT measurements pretransplant and at a median of 24 (range 18–24) months posttransplant, showed no evidence of disease progression.ConclusionBased on IMT measurements and clinical results, KP transplantation stabilized PAD in most patients, but did not alter outcomes of symptomatic PAD recipients. A pretransplant history of PAD and CAD was an independent predictor of posttransplant PAD events. 10.1111/ctr.15413 http://onlinelibrary.wiley.com/termsAndConditions#vor
doi_str_mv	10.1111/ctr.15413
format	Artículo Open Access
id	wiley_oa_10_1111_ctr_15413
institution	Wiley Open Access
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spellingShingle	The Impact of Kidney/Pancreas Transplantation on Peripheral Arterial Disease Richard J. Knight Yan Ye Edward A. Graviss Duc T. Nguyen Zsolt Garami Stephanie G. Yi Mark Hobeika Charudatta S. Bavare Archana R. Sadhu A. Osama Gaber Clinical Transplantation The Impact of Kidney/Pancreas Transplantation on Peripheral Arterial Disease Richard J. Knight Yan Ye Edward A. Graviss Duc T. Nguyen Zsolt Garami Stephanie G. Yi Mark Hobeika Charudatta S. Bavare Archana R. Sadhu A. Osama Gaber Clinical Transplantation ABSTRACTIntroductionIt is unclear whether kidney/pancreas (KP) transplantation will prevent the progression of peripheral arterial disease (PAD) in patients with insulin dependent diabetes (IDDM) and end‐stage renal disease. We sought to determine the pre‐ and posttransplant prevalence of symptomatic PAD and changes in carotid artery intima‐media thickness (IMT) in KP recipients.MethodsIn this single center study, outcomes were compared between KP recipients with and without a history of PAD. A subset of recipients underwent pre‐ and posttransplant IMT measurements.ResultsAmong the study group (N = 107), 18 (17%) recipients admitted to a pretransplant history of symptomatic PAD, comprised 11 foot infections and 7 amputations (5 minor and 2 major). Baseline characteristics of age, gender, race, years of diabetes, dialysis history, smoking history, years of hypertension, and history of coronary artery disease (CAD) were equivalent between PAD and non‐PAD cohorts. At a median follow‐up of 60 months (IQR: 28, 110), 16 (15%) KP recipients had suffered a PAD event. In multivariate analysis, a pretransplant history of PAD (hazard ratio [HR] 9.66, p < 0.001) and CAD (HR 3.33, p = 0.04) were independent predictors of posttransplant PAD events. Among a subset of 20 recipients (3 with PAD), mean IMT measurements pretransplant and at a median of 24 (range 18–24) months posttransplant, showed no evidence of disease progression.ConclusionBased on IMT measurements and clinical results, KP transplantation stabilized PAD in most patients, but did not alter outcomes of symptomatic PAD recipients. A pretransplant history of PAD and CAD was an independent predictor of posttransplant PAD events. 10.1111/ctr.15413 http://onlinelibrary.wiley.com/termsAndConditions#vor
title	The Impact of Kidney/Pancreas Transplantation on Peripheral Arterial Disease
topic	Clinical Transplantation
url	https://onlinelibrary.wiley.com/doi/10.1111/ctr.15413

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