LIPOPROTEIN-APOLIPOPROTEIN CHANGES IN RENAL-TRANSPLANT RECIPIENTS - A 2-YEAR FOLLOW-UP

Renal transplantation modifies the dyslipidemia characteristic of chronic renal failure (CRF). The change in lipoprotein and lipid values of 51 transplant recipients, on cyclosporine and corticosteroid treatment, was studied during 2 years after transplantation to examine the short- and medium-term variations of lipid metabolism. Compared with control values of (all in mg/dL) triglycerides (Tg) 111 ± 44, very-low-density lipoprotein (VLDL) Tg 69 ± 18, total cholesterol (Chol) 201 ± 32, VLDL-Chol 32 ± 9, low-density lipoprotein (LDL) Chol 118 ± 28, and high-density lipoprotein (HDL) Chol 50 ± 10, uremic patients pretransplantation exhibited values of Tg 200 ± 82 (P < .001), VLDL-Tg 133 ± 70 (P < .001), Chol 193 ± 51 (NS), VLDL-Chol 52 ± 16 (P < .001), LDL-Chol 100 ± 37 (P < .007), HDL-Chol 40 ± 16 (P < .001), which changed to Tg 118 ± 18 (P < .001), VLDL-Tg 64 ± 45 (P < .001), Chol 223 ± 48 (P < .006), VLDL-Chol 26 ± 33 (P < .001), LDL-Chol 134 ± 43 (P < .001), at HDL-Chol 63 ± 21 (P < .001) at 3 months and Tg 135 ± 76, VLDL-Tg 81 ± 62, Chol 218 ± 55, VLDL-Chol 22 ± 20, LDL-Chol 139 ± 46, and HDL-Chol 58 ± 18 at 24 months without evidence of a significative variations in the 3- to 24-month posttransplant period. Apolipoprotein (apo) B was significantly increased at the third month and then remained the same until 2 years, whereas both apo AI and apo CIII decreased significantly between 3 and 24 months. These data show that lipid metabolism after transplantation goes through two interlinked stages: a decrease in circulating Tg-rich lipoproteins, and an increase in the levels of some of the lipoproteins that carry cholesterol. These changes in the lipid picture usually appear in the first 3 months, after which plasma lipoprotein levels remain constant for up to 2 years. © 1991.