Effect of probucol on hypercholesterolemia in renal transplant patients

Background. Hypercholesterolemia is a well-known complication in kidney tra nsplant recipients, although its pathogenesis may be multifactorial. The th erapeutic effect of probucol on post-transplant hypercholesterolemia was pr ospectively evaluated. Methods. Twelve hypercholesterolemic kidney transplant patients with serum total cholesterol greater than or equal to 250 mg/dl without diabetes melli tus or hypoproteinemia were prospectively treated with probucol (250 mg, bi d, for three months). Before initiating and at the end of treatment, blood was drawn after at least a 12-hour fast to measure lipids in serum and lipo protein fractions, apoproteins (apo), lipoprotein fractions, lethicin chole sterol acyl transferase (LCAT), free fatty acids (FFAs), and cholesterol es ter. The lipid profiles of 17 healthy subjects were also examined. Results. After treatment with probucol, serum total cholesterol, low-densit y lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol , and apo AI were significantly decreased, whereas cholesterol ester increa sed significantly. Conclusions. Post-transplant hypercholesterolemia is featured with abnormal ities in very low-density lipoprotein (VLDL) metabolism. Although HDL chole sterol decreased, probucol might have acted as an antiatherogenic by modula ting HDL metabolism and stimulating reverse transfer of cholesterol from pe ripheral tissue.