The Impact of Deceased Donor Simvastatin Treatment on Kidney Transplant Outcomes - Results of a Double-Blinded, Randomized Controlled Trial

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Abstract

Background

In heart transplantation (HTx), postoperative statin treatment has been shown to reduce cardiac allograft vasculopathy (CAV) and long-term mortality. We have previously shown that donor simvastatin treatment reduces ischemia-reperfusion injury and development of CAV in animal HTx models. Recently, we were also able to show that donor simvastatin decreases ischemia-reperfusion injury in clinical HTx (unpublished). However, HTx donors are multi-organ donors, and the effect of donor simvastatin treatment on kidney allograft remains unknown.

Methods

We randomized 84 HTx donors into equal groups to receive either 80 mg of simvastatin or nothing through nasogastric tube at the time of acceptance as a donor. All donors also donated one or both kidneys. We collected relevant clinical data and postoperative laboratory markers from both donors and kidney recipients. Kidney recipients were followed up for (currently) 1 year for rejections, mortality, plasma creatinine, acute kidney injury marker (NGAL), and kidney function.

Results

In total, 115 adult single kidney transplants were performed. Of these, 61 recipients received kidney from a simvastatin treated donor, and 54 from a control donor. There were three allografts that did not start at all due to thrombosis, two in simvastatin group and one in control group. The overall incidence of delayed graft function was 36%. The overall incidence of rejection in the first year was 16%. There were no significant differences in any of the measured follow-up parameters between donor treated allografts and controls.

Conclusions

Our results suggest that donor simvastatin treatment has little effect on kidney allograft outcome. More importantly, however, treating multi-organ donor with simvastatin in order to protect the heart is safe from the perspective of kidney allografts.

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