HYPERHOMOCYSTEINAEMIA IN HEART-TRANSPLANT RECIPIENTS

The aim of this study was to determine the prevalence of hyperhomocysteinaemia in cardiac transplant recipients, Three groups of subjects were studied: 27 heart transplant recipients, 14 to 63 months (mean=36.5) after transplantation; 10 patients with moderate chronic renal insufficiency without clinical evidence of vascular disease; 17 apparently healthy individuals. Twenty-five out of 27 transplanted patients had a coronaroangiography within 6 months of homocysteine measurement. Plasma homocysteine was measured both while the subject was fasting (tO) and 6 h after administration of 0.1 g. kg-1 of methionine (t6). Hyperhomocysteinaemia was present in 14127 fasting transplanted patients and after methionine loading. Mean plasma levels of homocysteine at tO were higher (P=0.03) in transplanted heart recipients (15.4 ± 7μmol. l-1 than in the renal patients (9.9±5μmol. l-1) despite similar mean plasma creatinin. In eight transplanted patients with angiographic coronary abnormalities of the cardiac graft, homocysteinaemia was at tO 17.1 ±9 μmol. l-1 and at t6 47.8 ±25 μmol. l-1. In 17 transplanted patients with angiographically normal coronary arteries, plasma homocysteine levels were at tO, 13.2 ±4μmol. l-1 and at t6, 46.8±25μmol. l-1.We conclude that hyperhomocysteinaemia is common in transplanted heart recipients, and partly related to renal insufficiency. No correlation was found between hyperhomocysteinaemia and angiographic evidence of coronary atherosclerosis of the graft, but the population of the study was possibly too small to establish this correlation. © 1994 The European Society of Cardiology.