Patients with panel reactive antibodies (PRA) have many difficulties to find a crossmatch-negative kidney for transplantation and are at the risk of post transplantation rejection more than other transplanted patients. We evaluated the effect of simvastatin on PRA and post transplant outcome of these sensitized patients. In a prospective manner, 82 patients with end stage renal disease (ESRD) with a PRA >25% were evaluated. In a one year follow up the patients were treated with simvastatin. At the end of the second and 12th month PRA was rechecked. Those patients who underwent transplantation continued to take simvastatin six months after transplantation. Serum creatinine levels were checked at monthly intervals post operation. Fifty (61%) of sensitized patients were male. The patients were predominantly in the middle-aged group, mostly on a hemodialysis program. 39% of patients had a history of a previous renal transplant and 13.4% had a history of blood products transfusion. The major known cause of ESRD was glomerulonephritis. All of them took simvastatin for 2 months. The mean PRA 19.63 during this period. 34.1% showed a complete responsedecrement was 14.22 (i.e. PRA <25%). Six patients gave up the follow up (F/U) program and one patient died (not due to simvastatin side effects). Other 75 patients continued to take simvastatin for 12 month. At the end of the 12th month the mean PRA 26.10) which was significant in comparison with the initialdecrement was (26.57 values (P<0.05). Overall 53 patients showed a complete response to simvastatin. Twenty five patients underwent renal transplant. 3 patients discontinued the F/U program. Of the other 22 patients, only two patients became dependent on hemodialysis again. In conclusion, Simvastatin can safely be used to lower PRA and improve post transplant outcome.
Volume : 6
Issue : 4
Pages : 13
Nephrology and Urology Research Center, Shiraz Transplant Center, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran