scholarly journals Adipose-Derived Stem/Stromal Cells in Kidney Transplantation: Status Quo and Future Perspectives

2021 ◽  
Vol 22 (20) ◽  
pp. 11188
Author(s):  
Gabriele Storti ◽  
Evaldo Favi ◽  
Francesca Albanesi ◽  
Bong-Sung Kim ◽  
Valerio Cervelli
Keyword(s):  
Kidney Transplantation ◽  
Stromal Cells ◽  
Ischemia Reperfusion Injury ◽  
Current Knowledge ◽  
Ischemia Reperfusion ◽  
Graft Function ◽  
Future Perspective ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Impact

Kidney transplantation (KT) is the gold standard treatment of end-stage renal disease. Despite progressive advances in organ preservation, surgical technique, intensive care, and immunosuppression, long-term allograft survival has not significantly improved. Among the many peri-operative complications that can jeopardize transplant outcomes, ischemia–reperfusion injury (IRI) deserves special consideration as it is associated with delayed graft function, acute rejection, and premature transplant loss. Over the years, several strategies have been proposed to mitigate the impact of IRI and favor tolerance, with rather disappointing results. There is mounting evidence that adipose stem/stromal cells (ASCs) possess specific characteristics that could help prevent, reduce, or reverse IRI. Immunomodulating and tolerogenic properties have also been suggested, thus leading to the development of ASC-based prophylactic and therapeutic strategies in pre-clinical and clinical models of renal IRI and allograft rejection. ASCs are copious, easy to harvest, and readily expandable in culture. Furthermore, ASCs can secrete extracellular vesicles (EV) which may act as powerful mediators of tissue repair and tolerance. In the present review, we discuss the current knowledge on the mechanisms of action and therapeutic opportunities offered by ASCs and ASC-derived EVs in the KT setting. Most relevant pre-clinical and clinical studies as well as actual limitations and future perspective are highlighted.

Impact of smoking on kidney transplantation outcomes

2016 ◽  
Vol 88 (12) ◽  
pp. 45-50
Author(s):  
A G Stolyar ◽  
N A Tomilina
Keyword(s):  
Kidney Transplantation ◽  
Serum Creatinine ◽  
Graft Function ◽  
Left Ventricular ◽  
Patient Status ◽  
Postoperative Hypertension ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Impact ◽  
Transplantation Outcomes

Aim. To investigate the impact of smoking on kidney transplantation outcomes. Subjects and methods. The materials of 350 patients (including 229 (65.4%) men aged 37.1±0.6 years) who had undergone kidney allotransplantation (KAT) for end-stage renal disease were analyzed. The main outcomes of KAT (patient status (alive or dead); renal allograft (RAG) function or dysfunction; development of chronic transplant nephropathy (CTN)), were studied. Results. There were 52 (14.8%) smoking patients (50 (96.2%) men and 2 (3.8%) women). The survival rate of smokers after KAT was significantly lower (p=0.043), as was the duration of graft function in the smoking patients (p=0.038). There were statistically significant associations of smoking with age, sex, time to normalize post-KAT serum creatinine concentrations, the development of CTN and graft rejection crises, postoperative hypertension, post-KAT serum creatinine, hemoglobin, and albumin levels, pretransplantation alanine aminotransferase concentrations, pre-KAT left ventricular hypertrophy, patient compliance with the prescribed treatment regimen, the presence or absence of a job in the patient after KAT (p

scholarly journals Laparoscopic-Assisted Recipient Nephrectomy and Recipient Kidney Procurement during Orthotopic Living-Related Kidney Transplantation

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Dimitri Mikhalski ◽  
Karl Martin Wissing ◽  
Renaud Bollens ◽  
Daniel Abramowicz ◽  
Vincent Donckier ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Antiphospholipid Antibodies ◽  
Graft Function ◽  
Renal Vessels ◽  
Short Period ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage ◽  
Living Related ◽  
Laparoscopic Assisted

Advanced atherosclerosis or thrombosis of iliac vessels can constitute an absolute contraindication for heterotopic kidney transplantation. We report the case of a 42-year-old women with end-stage renal disease due to lupus nephritis and a history of bilateral thrombosis of iliac arteries caused by antiphospholipid antibodies. Occlusion had been treated by the bilateral placement of wall stents which precluded vascular anastomosis. The patient was transplanted with a right kidney procured by laparoscopic nephrectomy from her HLA semi-identical sister. The recipient had left nephrectomy after laparoscopical transperitoneal dissection. The donor kidney was orthotopically transplanted with end-to-end anastomosis of graft vessels to native renal vessels and of the graft and native ureter. Although, the patient received full anticoagulation because of a cardiac valve and antiphospholipid antibodies, she had no postoperative complication in spite of a short period of delayed graft function. Serum creatinine levels three months after transplantation were at 1.0 mg/dl. Our case documents that orthotopical transplantation of laparoscopically procured living donor kidneys at the site of recipient nephrectomy is a feasible procedure in patients with surgical contraindication of standard heterotopic kidney transplantation.

Prognostic value of endogenous and exogenous metabolites in liver transplantation

2020 ◽  
Vol 14 (12) ◽  
pp. 1165-1181
Author(s):  
Xiao-fu Xiong ◽  
Ding-ding Chen ◽  
Huai-jun Zhu ◽  
Wei-hong Ge
Keyword(s):  
Liver Transplantation ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Immunosuppressive Agents ◽  
Graft Function ◽  
Individual Variability ◽  
Pathological Examination ◽  
Biochemical Tests ◽  
Monitoring Method ◽  
End Stage

Liver transplantation has been widely accepted as an effective intervention for end-stage liver diseases and early hepatocellular carcinomas. However, a variety of postoperative complications and adverse reactions have baffled medical staff and patients. Currently, transplantation monitoring relies primarily on nonspecific biochemical tests, whereas diagnosis of multiple complications depends on invasive pathological examination. Therefore, a noninvasive monitoring method with high selectivity and specificity is desperately needed. This review summarized the potential of endogenous small-molecule metabolites as biomarkers for assessing graft function, ischemia-reperfusion injury and liver rejection. Exogenous metabolites, mainly those immunosuppressive agents with high intra- and inter-individual variability, were also discussed for transplantation monitoring.

scholarly journals Corin Is Downregulated in Renal Ischemia/Reperfusion Injury and Is Associated with Delayed Graft Function after Kidney Transplantation

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Xinyi Hu ◽  
Ming Su ◽  
Jun Lin ◽  
Lei Zhang ◽  
Wen Sun ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Differentially Expressed Genes ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Graft Function ◽  
Renal Ischemia ◽  
Delayed Graft Function ◽  
Differentially Expressed ◽  
Potential Biomarker ◽  
Renal Ischemia Reperfusion Injury

Renal ischemia/reperfusion (IR) injury is one of the most important risk factors for the occurrence of delayed graft function (DGF) after kidney transplantation; however, its mechanism remains not fully understood. In the present study, we screened differentially expressed genes in a murine model of renal IR injury by using high-throughput assays. We identified Corin as one of the most significantly downregulated genes among 2218 differentially expressed genes (≥2-fold, P<0.05). By using a real-time qPCR assay, we observed that the expression of renal Corin in IR-injured mice was reduced to 11.5% of the sham-operated mice and that the protein level of renal Corin in IR-injured mice was also downregulated. Interestingly, renal IR injury in mice induced the downregulation of Corin in heart tissues, suggesting that the overall synthesis of Corin may be suppressed. We recruited 11 recipients complicated with DGF and 16 without DGF, and plasma Corin concentrations were determined by ELISA. We observed that the plasma Corin levels were indeed reduced in recipients complicated with DGF (0.98 vs. 1.95 ng/ml, P<0.05). These findings demonstrate that Corin may be a potential biomarker of DGF after kidney transplantation and may participate in the regulation of renal IR injury.

scholarly journals Robot-assisted kidney transplantation. First experience

2020 ◽  
Vol 22 (2) ◽  
pp. 125-131
Author(s):  
S. V. Shchekaturov ◽  
I. V. Semeniakin ◽  
A. K. Zokoev ◽  
T. B. Makhmudov ◽  
R. R. Poghosyan
Keyword(s):  
Kidney Transplantation ◽  
Renal Disease ◽  
Kidney Transplant ◽  
End Stage Renal Disease ◽  
Graft Function ◽  
Surgical Techniques ◽  
Clinical Report ◽  
Robot Assisted ◽  
Stage Renal Disease ◽  
End Stage

Kidney transplantation is the preferred renal replacement therapy for patients with end-stage renal disease. Traditional surgical approaches consisting of vascular and urinary outflow reconstruction during kidney transplant have been sufficiently studied and standardized. However, surgical techniques are still evolving. The objective of this clinical report is to focus the attention of kidney transplant surgeons and specialists on the currently trending robot-assisted kidney transplantation (RAKT) as a minimally invasive procedure for surgical treatment of patients with end-stage renal disease. In our first experience, good primary graft function was achieved. This shows that RAKT is a surgical option. With considerable number of surgeries and experience, RAKT outcomes would be improved significantly.

scholarly journals The Impact of Histologic Variants on FSGS Outcomes

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Kristin Meliambro ◽  
Monica Schwartzman ◽  
Paolo Cravedi ◽  
Kirk N. Campbell
Keyword(s):  
Kidney Transplantation ◽  
End Stage Renal Disease ◽  
Clinical Course ◽  
Steroid Resistance ◽  
Favorable Prognosis ◽  
Interpretation Errors ◽  
Risk Of Disease ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Impact

Focal segmental glomerulosclerosis (FSGS) is the most common glomerular disease leading to end-stage renal disease. The clinical course is highly variable with disparate responses to therapeutic intervention and rates of progression. Histologic variant subtype has been commonly used as a prognostic and therapeutic guide in the clinical management of FSGS. The tip lesion is widely considered to portend the most favorable prognosis and to be the most responsive to steroid therapy. Conversely, the collapsing lesion, more prevalent in patients of African descent, is associated with steroid resistance and higher risk of disease progression. In the 10 years since the Columbia classification system for FSGS was published, some retrospective and one prospective study explored the impact of histologic variants at the time of biopsy on FSGS outcomes. The results largely validate its clinical predictive value with respect to treatment response, though its utility in cases recurring after kidney transplantation is still unknown. Sampling and interpretation errors are additional sources of caution. More research is needed to fully define reproducible prognostic and therapeutic markers for this polymorphic disorder.

scholarly journals Novel Insights into the Molecular Mechanisms of Ischemia/Reperfusion Injury in Kidney Transplantation

2021 ◽  
Vol 2 (2) ◽  
pp. 191-207
Author(s):  
Davide Loizzo ◽  
Nicola Antonio di Meo ◽  
Mattia Rocco Peluso ◽  
Monica Rutigliano ◽  
Matteo Matera ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Reperfusion Injury ◽  
Molecular Mechanisms ◽  
Ischemia Reperfusion Injury ◽  
Interstitial Fibrosis ◽  
Ischemia Reperfusion ◽  
Graft Function ◽  
Adaptive Immune Response ◽  
Tubular Atrophy ◽  
Pleiotropic Action

Ischemia reperfusion injury (IRI) is one of the most important mechanisms involved in delayed or reduced graft function after kidney transplantation. It is a complex pathophysiological process, followed by a pro-inflammatory response that enhances the immunogenicity of the graft and the risk of acute rejection. Many biologic processes are involved in its development, such as transcriptional reprogramming, the activation of apoptosis and cell death, endothelial dysfunction and the activation of the innate and adaptive immune response. Recent evidence has highlighted the importance of complement activation in IRI cascade, which expresses a pleiotropic action on tubular cells, on vascular cells (pericytes and endothelial cells) and on immune system cells. The effects of IRI in the long term lead to interstitial fibrosis and tubular atrophy, which contribute to chronic graft dysfunction and subsequently graft failure. Furthermore, several metabolic alterations occur upon IRI. Metabolomic analyses of IRI detected a “metabolic profile” of this process, in order to identify novel biomarkers that may potentially be useful for both early diagnosis and monitoring the therapeutic response. The aim of this review is to update the most relevant molecular mechanisms underlying IRI, and also to discuss potential therapeutic targets in future clinical practice.

scholarly journals The impact of desflurane and sevoflurane on the intraoperative and early postoperative period in liver transplantation

2021 ◽  
Vol 13 (4) ◽  
pp. 328-338
Author(s):  
S. V. Zhuravel ◽  
N. K. Kuznetsova ◽  
V. E. Aleksandrova ◽  
I. I. Goncharova
Keyword(s):  
Liver Transplantation ◽  
Reperfusion Injury ◽  
Postoperative Period ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Graft Function ◽  
Early Postoperative Period ◽  
Liver Graft ◽  
Inhalation Anesthetics ◽  
The Impact

Background. A pressing issue is the choice of an anesthetic agent for liver transplantation. The mechanism of the organprotective properties of desflurane and sevoflurane is not fully understood. It is important to understand the effects of desflurane and sevoflurane on the severity of ischemia-reperfusion injury of the liver graftAim. To study the effect of desflurane and sevoflurane on the intraoperative and early postoperative period in liver transplantation.Material and methods. The study included 47 patients with liver cirrhosis of various etiologies who underwent cadaveric liver transplantation between February and December 2020. The groups compared in the study included 24 patients who received desflurane and 23 patients who received sevoflurane.Results. There were no statistically significant differences in the effect of desflurane and sevoflurane on hemodynamic parameters, on the need for vasopressor drugs. Episodes of bradycardia and cardiac arrhythmias were significantly more frequent when using sevoflurane. Patients were extubated significantly faster after surgery in the desflurane group. In the early postoperative period, desflurane and sevoflurane did not adversely affect significantly the liver graft function and the degree of its ischemia-reperfusion injury. The groups appeared comparable in rates of using the renal replacement therapy, the incidence of the graft dysfunction development in the postoperative period, and the surgery outcomes.Conclusions. The use of modern inhalation anesthetics desflurane and sevoflurane to maintain anesthesia during liver transplantation does not adversely affect the course of the intraoperative and early postoperative period.

Sign in / Sign up

Export Citation Format

Share Document