IMPACT OF PANCREAS AND KIDNEY-TRANSPLANTATION ON DETERMINANTS OF BLOOD AND PLASMA VISCOSITY

Simultaneous pancreas and kidney transplantation (PKT) is associated w ith a deterioration of hemorheology. We investigated the determinants of plasma and blood viscosity (hct. 35%) after PKT (n = 49), in type 1 diabetes (n = 26) and in healthy controls (n = 24). Patients after PK T were subdivided due to their graft function (intact pancreas and kid ney graft, n = 26; pancreas rejected, intact kidney graft, n = 23). We examined the correlations of total serum protein, albumin, fibrinogen , alpha(2)-macroglobulin, total cholesterol, LDL cholesterol, HDL chol esterol and triglycerides with plasma and blood viscosity (hct. 35%) m easured at a continuous shear range of 600-0.2 s(-1) with a rotational viscometer (Haake, Germany). Total protein was strongly associated wi th plasma viscosity in all examined groups (r > 0.5, p < 0.03), it det ermined blood viscosity over the whole shear range in type 1 diabetic patients, but only at high shear rates after PKT (greater than or equa l to 100 s(-1)). The strong association of albumin and blood viscosity in type 1 diabetes and in healthy controls (shear rates greater than or equal to 10 s(-1)) was not found after PKT. Fibrinogen correlated w ith plasma and blood viscosity (greater than or equal to 25 s(-1)) aft er PKT (p < 0.03) but not in type 1 diabetic patients or healthy contr ols. alpha(2)-macroglobulin correlated with plasma and high shear bloo d viscosity after PKT only after pancreas rejection, no correlation wa s found after successful PKT It also correlated with plasma and blood viscosity at low and high shear rates in type 1 diabetes. Total choles terol and low shear blood viscosity correlated positively in successfu lly transplanted patients (r > 0.44), but negatively after pancreas re jection (r > -0.44). No correlation was found in type 1 diabetic patie nts, a positive association was found in healthy controls for plasma a nd low shear blood viscosity. LDL cholesterol correlated negatively (a fter pancreas rejection) or positively (healthy controls) with low she ar blood viscosity (p < 0.03) and positively with plasma viscosity. HD L cholesterol was negatively associated with high shear blood viscosit y in all groups (p < 0.05), except after successful PKT, where no asso ciation was found. It did not correlate with plasma viscosity in any g roup. Triglycerides did not contribute significantly to blood viscosit y in the examined groups. The metabolic alterations after PKT influenc e plasma proteins, lipids and corpuscular elements of blood with regar d to their effect on rheology.