Avaliação da laserdopplerfluxometria em pacientes submetidos a transplante renal e sua associação com a rejeição do enxerto

Abstract

Introduction: Renal transplantation is the definitive treatment for chronic kidney disease and capable of improving the quality of life of these patients. Postoperative acute graft rejection is highlighted as one of the most undesirable outcomes, characterized by microcirculation damage usually mediated by antibodies. Recently, the role of microcirculation alteration in renal transplant rejection has been studied, possibly impairment of endothelial regulation functions for vasodilation, associated with mild proliferation of smooth muscle cells and fibrinolysis, are responsible for a pro- Thrombotic and pro-inflammatory. Objective: to evaluate the correlation between renal graft rejection and microvascular reactivity. Method: This is a secondary study that has as an anchor project a PhD thesis. It is characterized as a longitudinal and prospective cohort study, where 34 newly transplanted patients (n = 34) were examined. Patients or their representatives were given a form containing identification, socio-demographic and clinical data. Afterwards, the patients were submitted to microcirculation - Laserdopplerfluxometry (LDF31) 01 week and 03 months after renal transplantation. The analysis was performed with the Stata 12.1SE software, adopting p ≤ 0.05. Results: In the general result there was no significant difference in the means of resting flow 1 and 2, maximum flow 1 and 2, MF / RF 1 and 2, area of hyperemia 1 and 2, area of occlusion 1 and 2, AH1 / AO 1 And 2, PORH 1 and 2, and inspiration 1 and 2 mean. However, in the microcirculation examination, there was a significant change in baseline flow mean (baseline 1 and 2) in response to brief arterial occlusion and in response to inspirations Depth (p-value ≤ 0.05). In addition, there were significant changes in the correlation of sociodemographic and clinical variables with the results of the microcirculation test. Conclusion: A correlation between endothelial function and socio-demographic and clinical variables, such as gender, age, race, comorbidities, life habits, early anemia, delayed graft function, acute rejection and loss of renal graft were observed Submitted to renal transplantation of IMIP.