P274
IS STATIN USE ASSOCIATED WITH REDUCED INCIDENCE OF REJECTION IN RENAL
TRANSPLANT RECIPIENTS? A STUDY FROM NOTTINGHAM RENAL AND
TRANSPLANT UNIT
Zaibun Khan1, Priya Shenton1, Vincent Wilson1, Catherine Byrne2 and Magdi Shehata2. 1School
of Biomedical Sciences, Queens Medical Centre, Nottingham. 2Nottingham Renal and
Transplant unit, Nottingham City Hospital
BACKGROUND: Renal transplant recipients have high cardiovascular morbidity and mortality
partly due to the impact of adverse lipid profiles. Statins have an established role in correcting
dyslipidaemia and numerous studies have shown statins may also exhibit immunomodulatory effects.
There is interest in the impact of these effects on rejection rates in renal transplant recipients. We
analysed data to see if there was an association between statin use and the incidence and severity of
rejection episodes in renal transplant recipients.
METHODS: 161 patients who received a renal transplant between 1/1/98 and 10/10/07 were suitable
for this study. The cohort was divided into two groups. 87 patients had commenced statin treatment
prior to transplantation and 74 patients had no statin treatment. Patient demographics, date of
transplant, immunosuppressive therapy, HLA match and biopsy proven rejection episodes were
collected. Rejection was classified by severity using Banff criteria and its timing post transplantation
(early rejection occurred <6 months, late 6 months post transplant).
RESULTS: The mean age of patients receiving statin treatment compared to those receiving no
treatment was 49.2 and 38.9 years, respectively. Mean time post transplant was 3.7 years in patients
on statins and 5.6 years in patients not on statins, however 94% of patients that experienced rejection
did so within 4 years of receiving a new organ. Patients not on a statin had fewer co-morbidities, had
spent less time on dialysis prior to surgery and were more likely to have had a pre-emptive transplant
compared to those on statin therapy. There was no significant difference in either the
immunosuppressive regimens or HLA mismatching between the two groups.
In total 48 (29.8%) patients experienced at least one episode of rejection, 19 (21.8%) of these patients
were on a statin while 29 (39.2%) were not on a statin (p <0.05). The number of patients experiencing
late rejection was significantly lower in the group on statin therapy (2.3% versus 16.2%, p<0.01).
Mild rejection was significantly higher in those not receiving statins (32.4% versus 16.1%, P<0.05).
There was a trend towards reduced moderate rejection experienced by patients on statins.
CONCLUSION: Statins appear to have an immunomodulatory effect that may be of benefit to renal
transplant recipients in reducing the risk of rejection. This may potentially prolong graft survival but
needs extended follow up. In the meantime, should all transplant recipient patients be started on statin
therapy irrespective of baseline lipid profiles, and does timing of statin initiation play a major part?