Increased Prevalence of Anticardiolipin Antibodies in Renal Transplant Recipients

Dr. Oktay Oymak, Hacettepe Hastanesi, Nefroloji Bölümü, TR-06100 Ankara (Turkey) Table 1. Prevalence of raised IgG-aCLs and other data of hemodialysis (HD) renal transplantation (tx) and control groups Dear Sir, Patients with end-stage renal failure undergoing hemodialysis have been found to be associated with a highe frequency of raised anticardiolipin antibodies (aCLs) than healthy controls [1-5]. The presence of aCLs in hemodialysis patients has been related with clinical events such as recurrent arterial and venous thrombosis; however, the data reported by these studies are controversial. The prevalence of aCLs and their relation with thrombotic events in renal transplant recipients are not well known. We performed a cross-sectional study of IgGaCLs in hemodialysis patients and renal transplant recipients. The aims ofthe study were (a) to investigate the prevalence of IgG-aCLs in hemodialysis patients, renal transplant recipients and healthy controls, and (b) to find out whether there is an association of raised IgG-aCLs and thrombotic events in these groups. There were 45 end-stage renal failure patients (27 M, 18F; mean age 40) treated by hospitalbased hemodialysis in the hemodialysis group, 48 renal transplant recipients (31 M, 17F; mean age 38) in the transplant group, and 43 healthy subjects in the control group (25 M, 18F; mean age 39). None ofthe hemodialysis and renal transplant patients had collagen tissue disease based on clinical history and absence of autoantibodies such as rheumatoid factor and antinuclear antibodies. All patients in both groups were dia-lyzed using cuprophane dialysis membranes. The minimum transplantation time was 19 months. A triple drug regimen (azathioprine, cyclosporine and prednisolone) was used for maintenance immunosuppression in all renal transplant recipients and all had a serum creatinine level of 2 mg/dl or less. IgG-aCLs in serum were analyzed with an enzyme immunoassay method (BioHy-Thec, Israel). The mean concentration of IgG-aCLs ofthe control subjects was 6.9 ± 1.4 GPL units and 95% of values were below 15 GPL units. Therefore, we regarded only values above 15 GPL units as being raised. History of thrombotic events was obtained from the patients and their medical records.