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Prompt Thrombo-Infl...
Prompt Thrombo-Inflammatory Response to Ischemia-Reperfusion Injury and Kidney Transplant Outcomes
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- Strandberg, Gabriel (author)
- Lund University,Lunds universitet,Kirurgi,Forskargrupper vid Lunds universitet,Surgery,Lund University Research Groups
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- Öberg, Carl M. (author)
- Lund University,Lunds universitet,Njurmedicin,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Njurfysiologi och peritonealdialys,Forskargrupper vid Lunds universitet,Nephrology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Renal physiology and peritoneal dialysis,Lund University Research Groups
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- Blom, Anna M. (author)
- Lund University,Lunds universitet,Institutionen för translationell medicin,Medicinska fakulteten,Proteinkemi, Malmö,Forskargrupper vid Lunds universitet,Department of Translational Medicine,Faculty of Medicine,Protein Chemistry, Malmö,Lund University Research Groups
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- Slivca, Oleg (author)
- Lund University,Lunds universitet,Kirurgi,Forskargrupper vid Lunds universitet,Surgery,Lund University Research Groups
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- Berglund, David, 1984- (author)
- Uppsala University,Uppsala universitet,Vaskulärbiologi
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- Segelmark, Mårten (author)
- Lund University,Lunds universitet,Njurmedicin,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Autoimmunitet och njursjukdomar,Forskargrupper vid Lunds universitet,Lärare vid läkarprogrammet,Avdelningen för läkarprogrammets kursadministration,Utbildningsenheten,Kansli M,Nephrology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Autoimmunity and kidney diseases,Lund University Research Groups,Teachers at the Medical Programme,Division of Course Administration for the Medical Programme,The Education Office,Faculty Office - BMC
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- Nilsson, Bo (author)
- Uppsala University,Uppsala universitet,Vaskulärbiologi
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- Biglarnia, Ali -Reza (author)
- Skane Univ Hosp, Lund Univ, Dept Surg, Dept Clin Sci Malmö, Malmö, Sweden.;Lund Univ, Dept Surg, Dept Clin Sci Malmö, Ruth Lundskogs gata 10, S-20502 Malmö, Sweden.,Lund University
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(creator_code:org_t)
- Elsevier, 2023
- 2023
- English.
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In: KIDNEY INTERNATIONAL REPORTS. - : Elsevier. - 2468-0249. ; 8:12, s. 2592-2602
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Abstract
Subject headings
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- Introduction: In kidney transplantation (KT), the role of the intravascular innate immune system (IIIS) in response to ischemia-reperfusion injury (IRI) is not well-understood. Here, we studied parallel changes in the generation of key activation products of the proteolytic cascade systems of the IIIS following living donor (LD) and deceased donor (DD) transplantation and evaluated potential associations with clinical outcomes.Methods: In a cohort study, 63 patients undergoing LD (n = 26) and DD (n = 37) transplantation were prospectively included. Fifteen DD kidneys were preserved with hypothermic machine perfusion (HMP), and the remaining were cold stored. Activation products of the kallikrein-kinin, coagulation, and complement systems were measured in blood samples obtained systemically at baseline and locally from the transplant renal vein at 1, 10, and 30 minutes after reperfusion.Results: DD kidneys exhibited a prompt and interlinked activation of all 3 cascade systems of IIIS post-reperfusion, indicating a robust and local thrombo-inflammatory response to IRI. In this initial response, the complement activation product sC5b-9 exhibited a robust correlation with other IIIS activation markers and displayed a strong association with short-term and mid-term (24-month) graft dysfunction. In contrast, LD kidneys did not exhibit this thrombo-inflammatory response. The use of HMP was associated with reduced thromboinflammation and preserved mid-term kidney function.Conclusion: Kidneys from DD are vulnerable to a prompt thrombo-inflammatory response to IRI, which adversely affects both short-term and long-term allograft function. Strategies aimed at minimizing graft immunogenicity prior to reperfusion are crucial to mitigate the intricate inflammatory response to IRI.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
Keyword
- delayed graft function
- intravascular innate immune system
- ischemia-reperfusion injury
- kidney transplantation
- organ preservation
- thromboinflammation
- delayed graft function
- intravascular innate immune system
- ischemia-reperfusion injury
- kidney transplantation
- organ preservation
- thromboinflammation
Publication and Content Type
- ref (subject category)
- art (subject category)
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