Simvastatin therapy in lymphocyte cross-match-positive kidney transplantation candidates.
OBJECTIVE
Recent identification of several mechanisms by which statins decrease recruitment of monocytes and T cells into the arterial wall and inhibit both T-cell and B-cell activation and proliferation in vitro prompted us to study the immunomodulatory effects of statins. In this study, we examined the effect of simvastatin therapy on lymphocyte cross-match positivity in kidney transplantation candidates.


METHODS
Simvastatin therapy (20 mg/d) was administered to 25 patients (18 men, 7 women of mean age 34 +/- 11.7 years who displayed positive lymphocyte cross-matches between July 2002 and October 2004. The etiologies of end-stage renal disease were vesicoureteral reflux (n = 5), urinary stone disease (n = 4), glomerulonephritis (n = 6), amyloidosis secondary to familial Mediterranean fever (n = 1), and unknown (n = 9).


RESULTS
The lymphocyte cross-match became negative in 10 patients 4-9 months, and successful kidney transplantation was performed in 6 of them. The serum creatinine levels of these patients ranged between 0.8 and 1.4 mg/dL. Two patients required higher doses, but none suffered from adverse effects. The remaining 4 patients are still undergoing pretransplantation evaluation.


CONCLUSIONS
Simvastatin therapy seems to be a cost-effective and useful method for lymphocyte cross-match-positive kidney transplantation candidates compared with immunoadsorption or intravenous immunoglobulin use.
Yakupoglu
U
U
Akdeniz University Organ Transplantation Center, Antalya, Turkey. ulkemyakupoglu@yahoo.com
Kocak
H
H
Karatas
G U
GU
Yakupoglu
Y K
YK
Dinckan
A
A
Kececioglu
N
N
Gurkan
A
A
Demirbas
A
A
Yegin
O
O
Tuncer
M
M
D000328:Adult; D005260:Female; D006650:Histocompatibility Testing / Q000379:methods*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000145:classification / Q000209:etiology / Q000276:immunology* / Q000601:surgery; D016030:Kidney Transplantation / Q000276:immunology*; D008214:Lymphocytes / Q000187:drug effects / Q000276:immunology*; D008297:Male; D019821:Simvastatin / Q000627:therapeutic use*; D014850:Waiting Lists
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D019821:Simvastatin