Blood coagulation, fibrinolytic and inhibitory profiles in renal transplant recipients: comparison of cyclosporine and azathioprine.
Renal transplant recipients treated with cyclosporine (CS) have been reported to be at increased risk of thrombotic complications. The present study was intended to examine the blood coagulation, fibrinolytic, and inhibitory systems in such patients. Eight transplant recipients on maintenance immunosuppression with CS and prednisone were studied. Five transplant recipients maintained on azathioprine (AZA) and prednisone and 32 normal volunteers served as controls. Plasma antigen concentrations and/or activities of various proteins in the above pathways were measured. Both the CS and AZA groups exhibited significant elevations of factor IX activity, von Willebrand factor (vWF), D-dimer, protein C and tissue type plasminogen activator (t-PA) levels when compared with the normal controls. In addition, CS group showed a significant elevation of alpha 2-macroglobulin activity and AZA group showed a significant reduction in factor XII activity when compared with the normal controls. Comparison of data from CS and AZA groups revealed higher factor XII activity and vWF concentration in the former group. In conclusion, transplant recipients treated with long-term cyclosporine and prednisone exhibited significant elevation of plasma vWF, D-dimer and protein C concentrations. In addition, both CS and AZA-treated transplant recipients showed increased plasma concentrations of D-dimer and t-PA. The latter observations suggest in vivo thrombin generation, fibrin formation and degradation.
Vaziri
N D
ND
Department of Medicine, University of California, Irvine.
Ismail
M
M
Martin
D C
DC
Gonzales
E
E
D000328:Adult; D000925:Anticoagulants; D000990:Antithrombin III / Q000032:analysis / Q000187:drug effects; D001379:Azathioprine / Q000494:pharmacology*; D001777:Blood Coagulation / Q000187:drug effects*; D001779:Blood Coagulation Factors / Q000032:analysis / Q000187:drug effects; D016572:Cyclosporine / Q000494:pharmacology*; D005260:Female; D005340:Fibrinogen / Q000032:analysis / Q000187:drug effects; D005342:Fibrinolysis / Q000187:drug effects; D005353:Fibronectins / Q000032:analysis / Q000187:drug effects; D006801:Humans; D016030:Kidney Transplantation; D007704:Kininogens / Q000032:analysis / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D011486:Protein C / Q000032:analysis / Q000187:drug effects
D000925:Anticoagulants; D001779:Blood Coagulation Factors; D005353:Fibronectins; D007704:Kininogens; D011486:Protein C; D016572:Cyclosporine; D000990:Antithrombin III; D005340:Fibrinogen; D001379:Azathioprine