Sequential changes in plasma selenium concentration after cadaveric renal transplantation.
BACKGROUND
Previous investigations have shown that plasma selenium concentrations are significantly lower in patients with established chronic graft nephropathy (CGN) than in healthy transplant controls. The aims of this study were to determine when in the transplant process low selenium concentrations become apparent and to explore the relationship between selenium levels and risk factors for CGN.


METHODS
Plasma selenium concentrations were measured in 40 patients (20 receiving cyclosporin, 20 receiving tacrolimus) undergoing transplantation. Samples were obtained immediately before transplantation and at 3, 6 and 12 months after transplantation.


RESULTS
A low plasma selenium concentration was found in 30 patients at the time of transplantation but this had normalized in the majority of patients by 3 months. Plasma selenium concentrations at 3, 6 and 12 months were significantly higher than baseline values for both treatment arms, but were significantly lower at 3 months in patients who experienced either clinical acute rejection (CAR) or cytomegalovirus (CMV) infection during the preceding months.


CONCLUSIONS
Low plasma selenium concentrations are common at the time of transplantation but appear to normalize thereafter. The identification of low selenium levels in patients who experience CAR or CMV (two important risk factors for clinically apparent CGN) suggests that the relationship between selenium and CGN warrants further investigation.
Welsh Transplantation Research Group, Department of Surgery, University of Wales College of Medicine, Cardiff, UK. garethmorrisstiff@hotmail.com
G J
GJ
Morris-Stiff
D A
DA
Oleesky
S C
SC
Smith
W A
WA
Jurewicz
D000293:Adolescent; D000328:Adult; D000368:Aged; D002102:Cadaver; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006084:Graft Rejection / Q000097:blood; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000097:blood / Q000601:surgery; D016030:Kidney Transplantation / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000097:blood* / Q000209:etiology; D012643:Selenium / Q000097:blood*; D016559:Tacrolimus
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D012643:Selenium; D016559:Tacrolimus