Toxic effects of heavy metal exposure in solid organ transplant recipients

Q4 Medicine Transplantation Reports Pub Date : 2024-04-16 DOI:10.1016/j.tpr.2024.100151
Daniel Glicklich , Muhamad Mustafa , Kevin Wolfe
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Abstract

Heavy metal toxicity has recently been described in solid organ transplant recipients. Allograft dysfunction or failure associated with arsenic, cadmium, chromium, cobalt and lead exposure have been reported, largely in renal transplant recipients, but also in small numbers of heart transplant recipients and a few liver and lung recipients. Conclusions: [1] In kidney transplant patients, highest tertile arsenic, cadmium and lead plasma levels were associated with increased allograft loss, compared to lower tertile levels; [2] Deteriorating metal hip prostheses may rarely cause heart failure due to cobalt and chromium cardiac toxicity in heart transplant and non-heart transplant patients, which resolves with prosthesis replacement; [3] Heavy metal testing should be considered in patients with multiple risk factors including occupational and environmental exposure, lower socioeconomic status, and multiple morbidities which could be associated with heavy metal toxicity; [4] Chelation therapy, used successfully in some non-transplant patients with chronic renal failure, has not been used systematically in transplant patients and studies are needed

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重金属暴露对实体器官移植受者的毒性影响
最近在实体器官移植受者中发现了重金属毒性。与砷、镉、铬、钴和铅暴露相关的移植功能障碍或衰竭已有报道,主要发生在肾移植受者中,也有少量心脏移植受者和少数肝脏和肺部受者。结论[1)在肾移植患者中,砷、镉和铅血浆水平的最高三分位数与同种异体移植损失的增加有关,而低三分位数的水平则与同种异体移植损失的增加有关;(2)在心脏移植和非心脏移植患者中,金属髋关节假体的退化可能会在极少数情况下因钴和铬的心脏毒性而导致心力衰竭,这种情况在更换假体后即可缓解;[3] 对于具有多种风险因素(包括职业和环境接触、较低的社会经济地位以及可能与重金属毒性有关的多种疾病)的患者,应考虑进行重金属检测;[4] 螯合疗法已成功用于一些慢性肾功能衰竭的非移植患者,但尚未在移植患者中系统使用,因此需要进行研究。
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来源期刊
Transplantation Reports
Transplantation Reports Medicine-Transplantation
CiteScore
0.60
自引率
0.00%
发文量
24
审稿时长
101 days
期刊介绍: To provide to national and regional audiences experiences unique to them or confirming of broader concepts originating in large controlled trials. All aspects of organ, tissue and cell transplantation clinically and experimentally. Transplantation Reports will provide in-depth representation of emerging preclinical, impactful and clinical experiences. -Original basic or clinical science articles that represent initial limited experiences as preliminary reports. -Clinical trials of therapies previously well documented in large trials but now tested in limited, special, ethnic or clinically unique patient populations. -Case studies that confirm prior reports but have occurred in patients displaying unique clinical characteristics such as ethnicities or rarely associated co-morbidities. Transplantation Reports offers these benefits: -Fast and fair peer review -Rapid, article-based publication -Unrivalled visibility and exposure for your research -Immediate, free and permanent access to your paper on Science Direct -Immediately citable using the article DOI
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