scholarly journals Aggravation of fibrin deposition and microthrombus formation within the graft during kidney transplantation

2021 ◽  
Author(s):  
Tamar A.J. van den Berg ◽  
Marius C. van den Heuvel ◽  
Janneke Wiersema-Buist ◽  
Jelle Adelmeijer ◽  
Gertrude J. Nieuwenhuijs-Moeke ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Living Donor ◽  
Graft Function ◽  
Deceased Donor ◽  
Potential Difference ◽  
Fibrin Deposition ◽  
Peritubular Capillaries ◽  
Deposition Intensity

Abstract In kidney transplantation, microthrombi and fibrin deposition may lead to local perfusion disorders and subsequently poor initial graft function. Microthrombi are often regarded as donor-derived. However, the incidence, time of development, and potential difference between living donor kidneys (LDK) and deceased donor kidneys(DDK), remains unclear. Two open-needle biopsies, taken at preimplantation and after reperfusion, were obtained from 17 LDK and 28 DDK transplanted between 2005 and 2008. Paraffin-embedded sections were immunohistochemically stained with anti-fibrinogen antibody. Fibrin deposition intensity in peritubular capillaries(PTC) and glomeruli was categorized as negative, weak, moderate or strong and the number of microthrombi/mm2 was quantified. Reperfusion biopsies showed more fibrin deposition (20–100% moderate/strong, p < 0.001) and more microthrombi/mm2 (0.97 ± 1.12 vs. 0.28 ± 0.53, p < 0.01) than preimplantation biopsies. In addition, more microthrombi/mm2 (0.38 ± 0.61 vs. 0.09 ± 0.22, p = 0.02) and stronger fibrin intensity in glomeruli (28% vs. 0%, p < 0.01) and PTC (14% vs. 0%, p = 0.02) were observed in preimplantation DDK than LDK biopsies. After reperfusion, microthrombi/mm2 were comparable (p = 0.23) for LDK (0.09 ± 0.22 to 0.76 ± 0.49, p = 0.03) and DDK (0.38 ± 0.61 to 0.90 ± 1.11, p = 0.07). Upon reperfusion, there is an aggravation of microthrombus formation and fibrin deposition within the graft. The prominent increase of microthrombi in LDK indicates that they are not merely donor-derived.

scholarly journals Aggravation of fibrin deposition and microthrombus formation within the graft during kidney transplantation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tamar A. J. van den Berg ◽  
Marius C. van den Heuvel ◽  
Janneke Wiersema-Buist ◽  
Jelle Adelmeijer ◽  
Gertrude J. Nieuwenhuijs-Moeke ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Living Donor ◽  
Graft Function ◽  
Deceased Donor ◽  
Potential Difference ◽  
Fibrin Deposition ◽  
Peritubular Capillaries ◽  
Deposition Intensity

AbstractIn kidney transplantation, microthrombi and fibrin deposition may lead to local perfusion disorders and subsequently poor initial graft function. Microthrombi are often regarded as donor-derived. However, the incidence, time of development, and potential difference between living donor kidneys (LDK) and deceased donor kidneys(DDK), remains unclear. Two open-needle biopsies, taken at preimplantation and after reperfusion, were obtained from 17 LDK and 28 DDK transplanted between 2005 and 2008. Paraffin-embedded sections were immunohistochemically stained with anti-fibrinogen antibody. Fibrin deposition intensity in peritubular capillaries(PTC) and glomeruli was categorized as negative, weak, moderate or strong and the number of microthrombi/mm2 was quantified. Reperfusion biopsies showed more fibrin deposition (20% to 100% moderate/strong, p < 0.001) and more microthrombi/mm2 (0.97 ± 1.12 vs. 0.28 ± 0.53, p < 0.01) than preimplantation biopsies. In addition, more microthrombi/mm2 (0.38 ± 0.61 vs. 0.09 ± 0.22, p = 0.02) and stronger fibrin intensity in glomeruli (28% vs. 0%, p < 0.01) and PTC (14% vs. 0%, p = 0.02) were observed in preimplantation DDK than LDK biopsies. After reperfusion, microthrombi/mm2 were comparable (p = 0.23) for LDK (0.09 ± 0.22 to 0.76 ± 0.49, p = 0.03) and DDK (0.38 ± 0.61 to 0.90 ± 1.11, p = 0.07). Upon reperfusion, there is an aggravation of microthrombus formation and fibrin deposition within the graft. The prominent increase of microthrombi in LDK indicates that they are not merely donor-derived.

scholarly journals Gene Expression Profile in Delay Graft Function: Inflammatory Markers Are Associated with Recipient and Donor Risk Factors

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Diego Guerrieri ◽  
Luis Re ◽  
Jorgelina Petroni ◽  
Nella Ambrosi ◽  
Roxana E. Pilotti ◽  
...  
Keyword(s):  
Gene Expression ◽  
Risk Factors ◽  
Kidney Transplantation ◽  
Inflammatory Markers ◽  
Graft Function ◽  
Deceased Donor ◽  
Specific Pattern ◽  
Inflammatory Gene Expression ◽  
Inflammatory Gene ◽  
Recipient Age

Background.Delayed graft function (DGF) remains an important problem after kidney transplantation and reduced long-term graft survival of the transplanted organ. The aim of the present study was to determine if the development of DGF was associated with a specific pattern of inflammatory gene expression in expanded criteria of deceased donor kidney transplantation. Also, we explored the presence of correlations between DGF risk factors and the profile that was found.Methods.Seven days after kidney transplant, a cDNA microarray was performed on biopsies of graft from patients with and without DGF. Data was confirmed by real-time PCR. Correlations were performed between inflammatory gene expression and clinical risk factors.Results.From a total of 84 genes analyzed, 58 genes were upregulated while only 1 gene was downregulated in patients with DGF compared with no DGF (P=0.01). The most relevant genes fold changes observed was IFNA1, IL-10, IL-1F7, IL-1R1, HMOX-1, and TGF-β. The results were confirmed for IFNA1, IL-1R1, HMOX-1 and TGF-β. A correlation was observed between TGF-β, donor age, and preablation creatinine, but not body mass index (BMI). Also, TGF-βshowed an association with recipient age, while IFNA1 correlated with recipient BMI. Furthermore, TGF-β, IFNA1 and HMOX-1 correlated with several posttransplant kidney function markers, such as diuresis, ultrasound Doppler, and glycemia.Conclusions.Overall, the present study shows that DGF is associated with inflammatory markers, which are correlated with donor and recipient DGF risk factors.

scholarly journals COVID-19 and Living Donor Kidney Transplantation in Naples during the Pandemic

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Gaia Peluso ◽  
Silvia Campanile ◽  
Alessandro Scotti ◽  
Vincenzo Tammaro ◽  
Akbar Jamshidi ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Living Donor ◽  
Viral Infections ◽  
Elective Surgery ◽  
Deceased Donor ◽  
Kidney Transplants ◽  
Donor Kidney ◽  
Transplant Center ◽  
Living Donor Transplantation ◽  
Donor Kidney Transplantation

Introduction. SARS-CoV-2 is a virus that causes a potentially deadly syndrome that affects especially the respiratory tract. Kidney-transplanted patients are immunosuppressed and more susceptible to viral infections. We have examined our transplantation activity to explore the future role of kidney transplantation from deceased and living donors in COVID-19 era. Patients and Methods. The activity of our transplant center of Naples (one of the two transplant centers in Campania, South Italy) continued during the COVID-19 pandemic. We have analysed the kidney transplants carried out between March 9 and June 9, 2020, comparing these data with the numbers of procedures performed in the two previous years. Moreover, we have considered the possibility of performing living donor transplants during a worldwide pandemic. Results. From March 9, 2020, when the Italian lockdown begun, till June 9, 2020, five kidney transplants have been performed at our transplant center in Naples, all from deceased donors. The donors and the recipients have been screened for COVID-19 infection, and the patients, all asymptomatic, followed strict preventive measures and were fully informed about the risks of surgery and immunosuppression during a pandemic. All the transplanted patients remained COVID negative during the follow-up. The number of transplants performed has been constant compared to the same months of 2018 and 2019. In agreement with the patients, we decided to postpone living donor transplants to a period of greater control of the SARS-CoV-2 spread in Italy. Conclusion. Deceased donor kidney transplantation should continue, especially in a region with moderate risk, like Campania, with a more careful selection of donors and recipients, preferring standard donors and recipients without severe comorbidities. Living donor transplantation program, instead, should be postponed to a period of greater control of the SARS-CoV-2 spread, as it is an elective surgery and its delay does not determine additional risks for patients.

scholarly journals Endogenous intronic antisense long non-coding RNA, MGAT3-AS1, and kidney transplantation

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Subagini Nagarajah ◽  
Shengqiang Xia ◽  
Marianne Rasmussen ◽  
Martin Tepel
Keyword(s):  
Kidney Transplantation ◽  
Predictive Value ◽  
Graft Function ◽  
Deceased Donor ◽  
Delayed Graft Function ◽  
Transplant Recipients ◽  
Donor Kidney ◽  
Non Coding Rna ◽  
Deceased Donor Kidney ◽  
Long Non Coding Rna

Abstract β-1,4-mannosylglycoprotein 4-β-N-acetylglucosaminyltransferase (MGAT3) is a key molecule for the innate immune system. We tested the hypothesis that intronic antisense long non-coding RNA, MGAT3-AS1, can predict delayed allograft function after kidney transplantation. We prospectively assessed kidney function and MGAT3-AS1 in 129 incident deceased donor kidney transplant recipients before and after transplantation. MGAT3-AS1 levels were measured in mononuclear cells using qRT-PCR. Delayed graft function was defined by at least one dialysis session within 7 days of transplantation. Delayed graft function occurred in 22 out of 129 transplant recipients (17%). Median MGAT3-AS1 after transplantation was significantly lower in patients with delayed graft function compared to patients with immediate graft function (6.5 × 10−6, IQR 3.0 × 10−6 to 8.4 × 10−6; vs. 8.3 × 10−6, IQR 5.0 × 10−6 to 12.8 × 10−6; p < 0.05). The median preoperative MGAT3-AS1 was significantly lower in kidney recipients with delayed graft function (5.1 × 10−6, IQR, 2.4 × 10−6 to 6.8 × 10−6) compared to recipients with immediate graft function (8.9 × 10−6, IQR, 6.8 × 10−6 to 13.4 × 10−6; p < 0.05). Receiver-operator characteristics showed that preoperative MGAT3-AS1 predicted delayed graft function (area under curve, 0.83; 95% CI, 0.65 to 1.00; p < 0.01). We observed a positive predictive value of 0.57, and a negative predictive value of 0.95. Long non-coding RNA, MGAT3-AS1, indicates short-term outcome in patients with deceased donor kidney transplantation.

scholarly journals Urinary Biomarkers α-GST and π-GST for Evaluation and Monitoring in Living and Deceased Donor Kidney Grafts

2019 ◽  
Vol 8 (11) ◽  
pp. 1899 ◽  
Author(s):  
Shadi Katou ◽  
Brigitta Globke ◽  
M. Haluk Morgul ◽  
Thomas Vogel ◽  
Benjamin Struecker ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Graft Function ◽  
Rejection Sensitivity ◽  
Deceased Donor ◽  
Urine Samples ◽  
Kidney Graft ◽  
Donor Kidney ◽  
Kidney Recipients ◽  
Deceased Donor Kidney ◽  
Brain Dead

The aim of this study was to analyze the value of urine α- and π-GST in monitoring and predicting kidney graft function following transplantation. In addition, urine samples from corresponding organ donors was analyzed and compared with graft function after organ donation from brain-dead and living donors. Urine samples from brain-dead (n = 30) and living related (n = 50) donors and their corresponding recipients were analyzed before and after kidney transplantation. Urine α- and π-GST values were measured. Kidney recipients were grouped into patients with acute graft rejection (AGR), calcineurin inhibitor toxicity (CNI), and delayed graft function (DGF), and compared to those with unimpaired graft function. Urinary π-GST revealed significant differences in deceased kidney donor recipients with episodes of AGR or DGF at day one after transplantation (p = 0.0023 and p = 0.036, respectively). High π-GST values at postoperative day 1 (cutoff: >21.4 ng/mg urine creatinine (uCrea) or >18.3 ng/mg uCrea for AGR or DGF, respectively) distinguished between rejection and no rejection (sensitivity, 100%; specificity, 66.6%) as well as between DGF and normal-functioning grafts (sensitivity, 100%; specificity, 62.6%). In living donor recipients, urine levels of α- and π-GST were about 10 times lower than in deceased donor recipients. In deceased donors with impaired graft function in corresponding recipients, urinary α- and π-GST were elevated. α-GST values >33.97 ng/mg uCrea were indicative of AGR with a sensitivity and specificity of 77.7% and 100%, respectively. In deceased donor kidney transplantation, evaluation of urinary α- and π-GST seems to predict different events that deteriorate graft function. To elucidate the potential advantages of such biomarkers, further analysis is warranted.

Gene Expression Patterns in Deceased Donor Kidneys Developing Delayed Graft Function After Kidney Transplantation

2008 ◽  
Vol 85 (4) ◽  
pp. 626-635 ◽  
Author(s):  
Valeria R. Mas ◽  
Kellie J. Archer ◽  
Kenneth Yanek ◽  
Catherine I. Dumur ◽  
Maria I. Capparuccini ◽  
...  
Keyword(s):  
Gene Expression ◽  
Kidney Transplantation ◽  
Expression Patterns ◽  
Graft Function ◽  
Deceased Donor ◽  
Delayed Graft Function ◽  
Gene Expression Patterns

scholarly journals Early Graft Function After Living Donor Kidney Transplantation Predicts Rejection But Not Outcomes

2004 ◽  
Vol 4 (6) ◽  
pp. 971-979 ◽  
Author(s):  
Todd V. Brennan ◽  
Chris E. Freise ◽  
T. Florian Fuller ◽  
Alan Bostrom ◽  
Stephen J. Tomlanovich ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Living Donor ◽  
Graft Function ◽  
Donor Kidney ◽  
Living Donor Kidney Transplantation ◽  
Early Graft ◽  
Donor Kidney Transplantation ◽  
Living Donor Kidney
Sign in / Sign up

Export Citation Format

Share Document