Ischemia-reperfusion Injury in Kidney Transplantation from Non-heart Beating Donor – Do Antioxidants or Antiinflammatory Drugs Play Any Role?
Authors:
V. Třeška 1; J. Kobr 2; D. Hasman 1; J. Racek 3; L. Trefil 3; T. Reischig 4; O. Hes 5; V. Kuntscher 1; J. Moláček 1; Inka Třešková 1
Authors place of work:
Chirurgická klinika FN a LF UK v Plzni, přednosta: prof. MUDr. Vladislav Třeška, DrSc.
1; Dětská klinika FN a LF UK v Plzni, přednosta: doc. MUDr. Jiří Kobr, Ph. D.
2; Ústav klinické biochemie FN a LF UK v Plzni, přednosta: prof. MUDr. Jaroslav Racek, CSc.
3; I. interní klinika FN a LF UK v Plzni, přednosta: doc. MUDr. Martin Matějovič, Ph. D.
4; Šiklův patologicko-anatomický ústav FN a LF UK v Plzni, přednosta: prof. MUDr. Michal Michal, Ph. D.
5
Published in the journal:
Rozhl. Chir., 2009, roč. 88, č. 2, s. 65-68.
Category:
Monothematic special - Original
Summary
Background:
Ischemia reperfusion injury (IRI) represents a serious problem of transplanted kidneys from a non-heart-beating donor (NHBD). It is probably the main cause of primary afunction or delayed graft function. The aim of the experimental study was to demonstrate on an experimental model the possibilities of reduction of IRI by intravenous application of antioxidants or immunosuppressives to the recipient before the kidney transplantation.
Method:
Piglets weighing between 20–25kg were used (N = 45) for the experiment. Intravenous application of multivitamins (GI) and a combination of immunosuppressives (GII) was tested one hour before the kidney transplantation from the NHBD. As a control a group (GIII) with simple NHBD modelling was used. At intervals of 0, 20, 60 and 120 minutes after the kidney transplantation, plasma levels of malondiadehyde (MDA) and reduced glutathione (GSH) were assessed. Before and 120 minutes after transplantation tissue concentrations of both factors were assessed in the transplanted kidney.
Results:
A permanent increase in MDA plasma concentrations occurred in GIII. In GI and GII, after a temporary increase of MDA plasma levels in the first 20 minutes after reperfusion, there was their permanent decrease then. (p < 0.05, resp. p < 0.01). The differences in the MDA plasma levels of GI and GII groups did not reach statistical significance. The both groups differed from GIII (p < 0.001). GSH plasma levels and also tissue concentrations of MDA and GSH were not statistically significant in any group in the course of the experiment.
Conclusion:
Intravenous application of multivitamins or immunosuppressives before kidney transplantation could have a significant influence on the immediate function of transplanted kidneys from a NHBD.
Key words:
ischemia reperfusion injury – non heart beating donor – multivitamins – immunosuppressives
Zdroje
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Perspectives in Surgery
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