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Transplantology
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Advances in Cardiovascular Complications After Renal Transplantation
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Advances in Cardiovascular Complications After Renal Transplantation

A special issue of Transplantology (ISSN 2673-3943). This special issue belongs to the section "Solid Organ Transplantation".

Deadline for manuscript submissions: closed (31 December 2022) | Viewed by 13538

Special Issue Editor

Dr. Zbigniew Heleniak

E-Mail Website
Guest Editor
Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland
Interests: renal transplant; cardiovascular disease; hypertension; renin angiotensin aldosteron system

Special Issue Information

Dear Colleagues, 

The main cause of death in patients with chronic kidney disease (CKD), including dialysis and renal transplant recipients (RTRs), are cardiovascular (CV) system diseases. Among RTRs, CV incidents contribute to nearly half (42%) of deaths, and of these, 5% occur within the first 12 months after transplantation. Most of these patients die with a properly functioning graft; therefore, it is extremely important to assess CV risk before transplantation and in the years after transplantation. A proper CV risk assessment and correct treatment of patients, especially those with high CV risk, can help to reduce mortality rates among RTRs. 

The current Special Issue aims to present a multidisciplinary approach to CV complications in the RTR population. The present call for manuscripts is addressed at healthcare professionals who diagnose, treat, and conduct research on renal transplantation, with special emphasis on state-of-the-art therapeutics in cardiovascular disease in RTRs. Comprehensive reviews, as well as research (be it basic, translational, or clinical research) or even interesting case series or case reports are welcomed, with the goal to present new approaches in the clinical management of the patient, patients diagnosed with a cardiovascular disease after renal transplantation, new pharmacotherapeutic approaches, clinical trials on the pipeline, or even promising future therapeutic alternatives. 

Dr. Zbigniew Heleniak
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Transplantology is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • renal transplantation
  • cardiovascular disease
  • hypertension
  • hyperlipidemia
  • endothelium

Published Papers (5 papers)

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Research

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9 pages, 1370 KiB  
Article
Nutritional Predictors of Cardiovascular Risk in Patients after Kidney Transplantation-Pilot Study
by Sylwia Czaja-Stolc, Paulina Wołoszyk, Sylwia Małgorzewicz, Andrzej Chamienia, Michał Chmielewski, Zbigniew Heleniak and Alicja Dębska-Ślizień
Transplantology 2022, 3(2), 130-138; https://doi.org/10.3390/transplantology3020014 - 18 Apr 2022
Viewed by 1725
Abstract
Asymmetric dimethylarginine (ADMA) is a marker of endothelial damage. Research confirms the association of ADMA with an increased cardiovascular risk (CVR) among kidney transplant recipients (KTRs). Additionally, increased circulating levels of fibroblast growth factor 23 (FGF-23) are associated with pathological cardiac remodeling and [...] Read more.
Asymmetric dimethylarginine (ADMA) is a marker of endothelial damage. Research confirms the association of ADMA with an increased cardiovascular risk (CVR) among kidney transplant recipients (KTRs). Additionally, increased circulating levels of fibroblast growth factor 23 (FGF-23) are associated with pathological cardiac remodeling and vascular alterations. The aim of the study is the analysis of the relationship between ADMA, FGF-23, nutritional, biochemical parameters in healthy subjects and KTRs. 46 KTRs and 23 healthy volunteers at mean age of 50.8 ± 15.4 and 62.5 ± 10.7 years were enrolled. The anthropometric and biochemical parameters such as ADMA, FGF-23, albumin, prealbumin were assessed. Fat tissue mass among KTRs was 30.28 ± 9.73%, lean body mass 64.5 ± 14.8%. Overweight and obesity was presented by 65.2% of recipients. Albumin level was 38.54 ± 3.80 g/L, prealbumin 27.83 ± 7.30 mg/dL and were significantly lower than in the control (p < 0.05). Patients with ADMA > 0.66 µmol/L had a lower concentration of prealbumin, albumin and increased concentration of oxidized low density lipoprotein (oxLDL), high sensitive C-reactive protein (hsCRP) and FGF-23. FGF-23 was significantly higher in patients with higher hsCRP (p < 0.05). KTRs with elevated ADMA had a longer transplantation vintage, lower eGFR and higher albuminuria. Diabetes mellitus (DM) was associated with higher levels of ADMA and FGF-23. Even in stable KTRs a relationship between inflammatory state, nutritional status, graft function and endothelial dysfunction biomarkers was observed. Full article
(This article belongs to the Special Issue Advances in Cardiovascular Complications After Renal Transplantation)
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Review

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11 pages, 264 KiB  
Review
Safety of Non-Vitamin K Antagonist Oral Anticoagulant Treatment in Patients with Chronic Kidney Disease and Kidney Transplant Recipients
by Mikołaj Młyński, Mikołaj Sajek, Zbigniew Heleniak and Alicja Dębska-Ślizień
Transplantology 2022, 3(3), 208-218; https://doi.org/10.3390/transplantology3030022 - 28 Jun 2022
Viewed by 1977
Abstract
The use of novel oral anticoagulants in patients with impaired renal function or undergoing immunosuppressive therapy is limited due to the risk of drug-to-drug interactions and anticoagulation-related adverse events. This article aims to assess the current data on the safety of direct-acting oral [...] Read more.
The use of novel oral anticoagulants in patients with impaired renal function or undergoing immunosuppressive therapy is limited due to the risk of drug-to-drug interactions and anticoagulation-related adverse events. This article aims to assess the current data on the safety of direct-acting oral anticoagulant-based therapy in the population of kidney transplant recipients and patients with impaired renal function. The most important factors affecting the safety of treatment are the incidence of bleeding events, thromboembolic events, deaths and drug-to-drug interactions. The available data were compared to the findings on warfarin-based anticoagulation. Findings on the use of novel oral anticoagulants in kidney transplant recipients are limited yet promising in terms of safety and efficacy of use. However, current recommendations state that the co-administration of non-vitamin K antagonist oral anticoagulants with several immunosuppressive agents is contraindicated. Full article
(This article belongs to the Special Issue Advances in Cardiovascular Complications After Renal Transplantation)
12 pages, 750 KiB  
Review
Dyslipidemia in Renal Transplant Recipients
by Karolina Chmielnicka, Zbigniew Heleniak and Alicja Dębska-Ślizień
Transplantology 2022, 3(2), 188-199; https://doi.org/10.3390/transplantology3020020 - 23 May 2022
Cited by 3 | Viewed by 5323
Abstract
Dyslipidemia is a frequent complication after kidney transplantation (KT) and is an important risk factor for cardiovascular disease (CVD). Renal transplant recipients (RTRs) are considered at high, or very high, risk of CVD, which is a leading cause of death in this patient [...] Read more.
Dyslipidemia is a frequent complication after kidney transplantation (KT) and is an important risk factor for cardiovascular disease (CVD). Renal transplant recipients (RTRs) are considered at high, or very high, risk of CVD, which is a leading cause of death in this patient group. Despite many factors of post-transplant dyslipidemia, the immunosuppressive treatment has the biggest influence on a lipid profile. There are no strict dyslipidemia treatment guidelines for RTRs, but the ones proposing an individual approach regarding CVD risk seem most suitable. Proper diet and physical activity are the main general measures to manage dyslipidemia and should be introduced initially in every patient after KT. In the case of an insufficient correction of lipemia, statins are the basis for hypolipidemic treatment. Statins should be introduced with caution to avoid serious side-effects (e.g., myopathy) or drug-drug interactions, especially with immunosuppressants. To lower the incidence of adverse effects, and improve medication adherence, ezetimibe in combination with statins is recommended. Fibrates and bile sequestrants are not recommended due to their side-effects and variable efficacy. However, several new lipid-lowering drugs like Proprotein convertase subtilisin/Kexin type9 (PCSK9) inhibitors may have promising effects in RTRs, but further research assessing efficacy and safety is yet to be carried out. Full article
(This article belongs to the Special Issue Advances in Cardiovascular Complications After Renal Transplantation)
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13 pages, 744 KiB  
Review
Updated Pathways in Cardiorenal Continuum after Kidney Transplantation
by Agnė Laučytė-Cibulskienė, Ali-Reza Biglarnia, Carin Wallquist and Anders Christensson
Transplantology 2022, 3(2), 156-168; https://doi.org/10.3390/transplantology3020017 - 02 May 2022
Viewed by 1938
Abstract
Cardiovascular disease (CVD) remains one of the leading causes for increased morbidity and mortality in chronic kidney disease (CKD). Kidney transplantation is the preferred treatment option for CKD G5. Improved perioperative and postoperative care, personalized immunosuppressive regimes, and refined matching procedures of kidney [...] Read more.
Cardiovascular disease (CVD) remains one of the leading causes for increased morbidity and mortality in chronic kidney disease (CKD). Kidney transplantation is the preferred treatment option for CKD G5. Improved perioperative and postoperative care, personalized immunosuppressive regimes, and refined matching procedures of kidney transplants improves cardiovascular health in the early posttransplant period. However, the long-term burden of CVD is considerable. Previously underrecognized, the role of the complement system alongside innate immunity, inflammaging, structural changes in the glomerular filtration barrier and early vascular ageing also seem to play an important role in the posttransplant management. This review provides up-to-date knowledge on these pathways that may influence the cardiovascular and renal continuum and identifies potential targets for future therapies. Arterial destiffening strategies and the applicability of sodium-glucose cotransporter 2 inhibitors and their role in cardiovascular health after kidney transplantation are also addressed. Full article
(This article belongs to the Special Issue Advances in Cardiovascular Complications After Renal Transplantation)
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Other

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6 pages, 565 KiB  
Case Report
Kidney Re-Transplantation after Simultaneous Heart and Kidney Transplant: Case Study and Literature Review
by Antonina Przybył, Zbigniew Heleniak, Jarosław Kobiela, Iwona Stopczyńska, Marian Zembala, Michał Zakliczyński, Leszek Domański, Jacek Różański and Alicja Dębska-Ślizień
Transplantology 2022, 3(2), 124-129; https://doi.org/10.3390/transplantology3020013 - 14 Apr 2022
Viewed by 1958
Abstract
The kidney is one of most frequent transplants to be performed in multi-organ transplantation. A simultaneous heart and kidney transplant (SHKT) is the best-known treatment method in patients with severe heart failure and end-stage renal disease (ESRD). Here, the authors describe the case [...] Read more.
The kidney is one of most frequent transplants to be performed in multi-organ transplantation. A simultaneous heart and kidney transplant (SHKT) is the best-known treatment method in patients with severe heart failure and end-stage renal disease (ESRD). Here, the authors describe the case of a kidney re-transplantation after SHKT, which is in accordance with the majority of studies, and proves the safety of simultaneous procedures. The article highlights the complex care required after the transplant, followed by the multi-factor qualification for re-transplantation. In conclusion, the case shows that SHKT provides long-term favorable outcomes and enables a repeated kidney transplantation with satisfactory one-year follow-up results. Full article
(This article belongs to the Special Issue Advances in Cardiovascular Complications After Renal Transplantation)
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