Role Of The Fibrinolytic System In Renal Transplantation
To determine the importance of the fibrinolytic system in renal transplantation on the one hand, and to establish a correlation between possible endothelial damage due to treatment of the renal graft and fibrinolytic parameters on the other, dogs were divided in six groups. Group I dogs were subjected to anesthesia only. Group II was sham operated. In group III, kidneys were perfused with the supernatant of either autologous or homologous cryo-precipitated plasma, and in group IV with albumin. In group V kidneys were cold stored. This was followed by autotransplantation. In group VI kidneys were perfused with albumin and allografted. Before and after transplantation, total plasma plasminogen (pro) activator activities in systemic and renal circulations were measured on fibrin plates after the addition of dextran sulfate and flufenamate to euglobulin fractions. Vascular activator (VA) was measured by adding Cl-inactivator. There was no marked difference between groups III, IV and VI. In comparing, however, group V with any of the perfused groups, an overall higher fibrinolytic activity was recorded both for intrinsic activators (p<.001) and VA (p<.001). in group I a significant drop in both activities (p<.01 -<.02) could be directly related to the duration of anesthesia with recovery within 24 hours. This pattern, though highly accentuated, revealed itself in all the other groups studied, with VA temporarily reaching zero-levels in the renal circulation in group VI. This data indicates the participation of the fibrinolytic system, in particular of the VA, in determining the fate of renal grafts.