Cholesterol efflux capacity predicts graft failure in renal transplant

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  • In patients undergoing renal transplant, cholesterol efflux capacity is a strong predictor of graft failure, independent of plasma HDL-C levels
  • Study population: cohort of renal transplant recipients (n=495, median follow-up: 7.0 years)
  • Cholesterol efflux capacity was quantified at baseline using incubation of human macrophage foam cells with apolipoprotein B-depleted plasma
  • No difference in baseline efflux capacity between deceased patients and survivors (P=.60  for cardiovascular mortality; P=.50 for all-cause mortality)
  • Lower efflux capacity in patients with graft failure vs patients with functioning grafts (P<.001)
  • Baseline efflux capacity significantly predicted graft failure (HR, 0.43; 95% CI, 0.29 to 0.64; P<.001) independent of apolipoprotein A-I, HDL cholesterol, or creatinine clearance