Simvastatin therapy in lymphocyte cross-match-positive kidney transplantation candidates.

Abstract Objectives Recent identification of several mechanisms by which statins decrease recruitment of monocytes and T cells into the arterial wall and inhibit both T-cell and B-cell activation and proliferation in vitro prompted us to study the immunomodulatory effects of statins. In this study, we examined the effect of simvastatin therapy on lymphocyte cross-match positivity in kidney transplantation candidates. Methods Simvastatin therapy (20 mg/d) was administered to 25 patients (18 men, 7 women of mean age 34 ± 11.7 years who displayed positive lymphocyte cross-matches between July 2002 and October 2004. The etiologies of end-stage renal disease were vesicoureteral reflux ( n = 5), urinary stone disease ( n = 4), glomerulonephritis ( n = 6), amyloidosis secondary to familial Mediterranean fever ( n = 1), and unknown ( n = 9). Results The lymphocyte cross-match became negative in 10 patients 4–9 months, and successful kidney transplantation was performed in 6 of them. The serum creatinine levels of these patients ranged between 0.8 and 1.4 mg/dL. Two patients required higher doses, but none suffered from adverse effects. The remaining 4 patients are still undergoing pretransplantation evaluation. Conclusion Simvastatin therapy seems to be a cost-effective and useful method for lymphocyte cross-match–positive kidney transplantation candidates compared with immunoadsorption or intravenous immunoglobulin use.