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Knoedler L, Schaschinger T, Niederegger T, Hundeshagen G, Panayi AC, Cetrulo CL, Jeljeli M, Hofmann E, Heiland M, Koerdt S, Lellouch AG. Multi-Center Outcome Analysis of 16 Face Transplantations - A Retrospective OPTN Study. Transpl Int 2025; 38:14107. [PMID: 39944217 PMCID: PMC11813647 DOI: 10.3389/ti.2025.14107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2024] [Accepted: 01/09/2025] [Indexed: 05/09/2025]
Abstract
Facial Vascularized Composite Allotransplantation (fVCA) restores form and function for patients with severe facial disfigurements, yet multi-center outcome data remain scarce. We accessed the Organ Procurement and Transplantation Network (OPTN) database from 2008 to 2024 to identify all full- or partial-face fVCA recipients, excluding patients under 18 years and those with physiologically impossible BMIs. Of 25 identified patients, 16 (64%) met inclusion criteria (69% male; mean age 43 ± 14 years). Recipients experienced a median of 5 [IQR 0.0-10] acute rejection episodes, which correlated with inotrope use during donor procurement (p = 0.033). On average, patients were hospitalized 2.4 ± 1.8 times, with arginine vasopressin (AVP) administration linked to fewer hospitalizations (p = 0.035). Seven recipients (44%) experienced complications, and extended-criteria donor (ECD) status was associated with higher complication rates (p = 0.049). These findings underscore the promise of fVCA to address complex facial defects while identifying key risk factors-particularly inotrope use and ECD status, while AVP administration may mitigate hospital stays. Further studies with larger cohorts are warranted to refine perioperative strategies, improve outcomes, and expand the clinical utility of fVCA.
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Affiliation(s)
- Leonard Knoedler
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Thomas Schaschinger
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Tobias Niederegger
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Gabriel Hundeshagen
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Hospital Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany
- Department of Plastic and Hand Surgery, Burn Center, BG Trauma Hospital Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany
| | - Adriana C. Panayi
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Curtis L. Cetrulo
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Maxime Jeljeli
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Elena Hofmann
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Steffen Koerdt
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Alexandre G. Lellouch
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
- Shriners Children’s Boston, Boston, MA, United States
- Cedars-Sinai Medical Center, Los Angeles, CA, United States
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Juriasingani S, Vo V, Akbari M, Grewal J, Zhang M, Jiang J, Haig A, Sener A. Supplemental hydrogen sulfide in models of renal transplantation after cardiac death. Can J Surg 2022; 65:E193-E202. [PMID: 35292525 PMCID: PMC8929428 DOI: 10.1503/cjs.013920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2021] [Indexed: 12/26/2022] Open
Abstract
Background: The increasing use of kidneys from donations after cardiac death (DCD) for renal transplantation is hindered by negative outcomes owing to organ injury after prolonged warm and cold ischemia–reperfusion. Recently, hydrogen sulfide (H2S) has shown cytoprotective effects against ischemia–reperfusion injury; however, its effectiveness in the context of DCD renal transplantation is unknown. Methods: We tested a novel 30-day in vivo syngeneic murine model of DCD renal transplantation, in which the donor kidney was clamped for 30 minutes and stored for 18 hours in cold University of Wisconsin (UW) solution or UW with 150 μM sodium hydrogen sulfide (UW + NaHS) before transplantation. We also tested a 7-day in vivo porcine model of DCD renal autotransplantation, in which the left kidney was clamped for 60 minutes and preserved for 24 hours using hypothermic perfusion with UW or UW + 150 μM NaHS before autotransplantation. We collected blood and urine samples periodically, and collected kidney samples at the end point for histopathology and quantitative reverse transcription polymerase chain reaction. Results: Rats that received H2S-treated kidneys showed significantly higher survival, faster recovery of graft function and significantly lower acute tubular necrosis than controls. Pig kidneys perfused with UW + NaHS showed significantly higher renal blood flow and lower renal resistance than control kidneys after 24 hours of perfusion. After autotransplantation, pigs that received H2S-treated kidneys showed significantly lower serum creatinine on days 1 and 7 after transplantation. Rat and pig kidneys treated with H2S also showed more protective gene expression profiles than controls. Conclusion: Our findings support the potential use of H2S-supplemented UW solution during cold storage as a novel and practical means to improve DCD graft survival and function.
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Affiliation(s)
- Smriti Juriasingani
- From the Department of Microbiology & Immunology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ont. (Juriasingani, Vo, Akbari, Grewal, Zhang, Sener); the Matthew Mailing Centre for Translational Transplant Studies, University Hospital, London Health Sciences Centre, London, Ont. (Juriasingani, Vo, Akbari, Grewal, Zhang, Jiang, Sener); the Undergraduate Medical Education-MD program, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ont. (Vo); the Department of Pathology, Schulich School of Medicine & Dentistry, University of Western, London, Ont. (Haig); the Department of Surgery, Schulich School of Medicine & Dentistry, St. Joseph's Health Care, London, Ont. (Sener); and the Multi Organ Transplant Program, University Hospital, London Health Sciences Centre, London, Ont. (Sener)
| | - Vicky Vo
- From the Department of Microbiology & Immunology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ont. (Juriasingani, Vo, Akbari, Grewal, Zhang, Sener); the Matthew Mailing Centre for Translational Transplant Studies, University Hospital, London Health Sciences Centre, London, Ont. (Juriasingani, Vo, Akbari, Grewal, Zhang, Jiang, Sener); the Undergraduate Medical Education-MD program, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ont. (Vo); the Department of Pathology, Schulich School of Medicine & Dentistry, University of Western, London, Ont. (Haig); the Department of Surgery, Schulich School of Medicine & Dentistry, St. Joseph's Health Care, London, Ont. (Sener); and the Multi Organ Transplant Program, University Hospital, London Health Sciences Centre, London, Ont. (Sener)
| | - Masoud Akbari
- From the Department of Microbiology & Immunology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ont. (Juriasingani, Vo, Akbari, Grewal, Zhang, Sener); the Matthew Mailing Centre for Translational Transplant Studies, University Hospital, London Health Sciences Centre, London, Ont. (Juriasingani, Vo, Akbari, Grewal, Zhang, Jiang, Sener); the Undergraduate Medical Education-MD program, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ont. (Vo); the Department of Pathology, Schulich School of Medicine & Dentistry, University of Western, London, Ont. (Haig); the Department of Surgery, Schulich School of Medicine & Dentistry, St. Joseph's Health Care, London, Ont. (Sener); and the Multi Organ Transplant Program, University Hospital, London Health Sciences Centre, London, Ont. (Sener)
| | - Jaskiran Grewal
- From the Department of Microbiology & Immunology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ont. (Juriasingani, Vo, Akbari, Grewal, Zhang, Sener); the Matthew Mailing Centre for Translational Transplant Studies, University Hospital, London Health Sciences Centre, London, Ont. (Juriasingani, Vo, Akbari, Grewal, Zhang, Jiang, Sener); the Undergraduate Medical Education-MD program, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ont. (Vo); the Department of Pathology, Schulich School of Medicine & Dentistry, University of Western, London, Ont. (Haig); the Department of Surgery, Schulich School of Medicine & Dentistry, St. Joseph's Health Care, London, Ont. (Sener); and the Multi Organ Transplant Program, University Hospital, London Health Sciences Centre, London, Ont. (Sener)
| | - Max Zhang
- From the Department of Microbiology & Immunology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ont. (Juriasingani, Vo, Akbari, Grewal, Zhang, Sener); the Matthew Mailing Centre for Translational Transplant Studies, University Hospital, London Health Sciences Centre, London, Ont. (Juriasingani, Vo, Akbari, Grewal, Zhang, Jiang, Sener); the Undergraduate Medical Education-MD program, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ont. (Vo); the Department of Pathology, Schulich School of Medicine & Dentistry, University of Western, London, Ont. (Haig); the Department of Surgery, Schulich School of Medicine & Dentistry, St. Joseph's Health Care, London, Ont. (Sener); and the Multi Organ Transplant Program, University Hospital, London Health Sciences Centre, London, Ont. (Sener)
| | - Jifu Jiang
- From the Department of Microbiology & Immunology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ont. (Juriasingani, Vo, Akbari, Grewal, Zhang, Sener); the Matthew Mailing Centre for Translational Transplant Studies, University Hospital, London Health Sciences Centre, London, Ont. (Juriasingani, Vo, Akbari, Grewal, Zhang, Jiang, Sener); the Undergraduate Medical Education-MD program, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ont. (Vo); the Department of Pathology, Schulich School of Medicine & Dentistry, University of Western, London, Ont. (Haig); the Department of Surgery, Schulich School of Medicine & Dentistry, St. Joseph's Health Care, London, Ont. (Sener); and the Multi Organ Transplant Program, University Hospital, London Health Sciences Centre, London, Ont. (Sener)
| | - Aaron Haig
- From the Department of Microbiology & Immunology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ont. (Juriasingani, Vo, Akbari, Grewal, Zhang, Sener); the Matthew Mailing Centre for Translational Transplant Studies, University Hospital, London Health Sciences Centre, London, Ont. (Juriasingani, Vo, Akbari, Grewal, Zhang, Jiang, Sener); the Undergraduate Medical Education-MD program, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ont. (Vo); the Department of Pathology, Schulich School of Medicine & Dentistry, University of Western, London, Ont. (Haig); the Department of Surgery, Schulich School of Medicine & Dentistry, St. Joseph's Health Care, London, Ont. (Sener); and the Multi Organ Transplant Program, University Hospital, London Health Sciences Centre, London, Ont. (Sener)
| | - Alp Sener
- From the Department of Microbiology & Immunology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ont. (Juriasingani, Vo, Akbari, Grewal, Zhang, Sener); the Matthew Mailing Centre for Translational Transplant Studies, University Hospital, London Health Sciences Centre, London, Ont. (Juriasingani, Vo, Akbari, Grewal, Zhang, Jiang, Sener); the Undergraduate Medical Education-MD program, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ont. (Vo); the Department of Pathology, Schulich School of Medicine & Dentistry, University of Western, London, Ont. (Haig); the Department of Surgery, Schulich School of Medicine & Dentistry, St. Joseph's Health Care, London, Ont. (Sener); and the Multi Organ Transplant Program, University Hospital, London Health Sciences Centre, London, Ont. (Sener)
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Yang L, Chen X, Bi Z, Liao J, Zhao W, Huang W. Curcumin attenuates renal ischemia reperfusion injury via JNK pathway with the involvement of p300/CBP-mediated histone acetylation. THE KOREAN JOURNAL OF PHYSIOLOGY & PHARMACOLOGY : OFFICIAL JOURNAL OF THE KOREAN PHYSIOLOGICAL SOCIETY AND THE KOREAN SOCIETY OF PHARMACOLOGY 2021; 25:413-423. [PMID: 34448459 PMCID: PMC8405434 DOI: 10.4196/kjpp.2021.25.5.413] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 05/22/2021] [Accepted: 06/11/2021] [Indexed: 11/15/2022]
Abstract
Apoptosis is proved responsible for renal damage during ischemia/reperfusion. The regulation for renal apoptosis induced by ischemia/reperfusion injury (IRI) has still been unclearly characterized to date. In the present study, we investigated the regulation of histone acetylation on IRI-induced renal apoptosis and the molecular mechanisms in rats with the application of curcumin possessing a variety of biological activities involving inhibition of apoptosis. Sprague–Dawley rats were randomized into four experimental groups (SHAM, IRI, curcumin, SP600125). Results showed that curcumin significantly decreased renal apoptosis and caspase-3/-9 expression and enhanced renal function in IRI rats. Treatment with curcumin in IRI rats also led to the decrease in expression of p300/cyclic AMP response element-binding protein (CBP) and activity of histone acetyltransferases (HATs). Reduced histone H3 lysine 9 (H3K9) acetylation was found near the promoter region of caspase-3/-9 after curcumin treatment. In a similar way, SP600125, an inhibitor of c-Jun N-terminal kinase (JNK), also attenuated renal apoptosis and enhanced renal function in IRI rats. In addition, SP600125 suppressed the binding level of p300/CBP and H3K9 acetylation near the promoter region of caspase-3/-9, and curcumin could inhibit JNK phosphorylation like SP600125. These results indicate that curcumin could attenuate renal IRI via JNK/p300/CBP-mediated anti-apoptosis signaling.
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Affiliation(s)
- Lu Yang
- Department of Anesthesiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, P.R. China
| | - Xiaoxiang Chen
- Department of Anesthesiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, P.R. China
| | - Zirong Bi
- Department of Organ Transplantation, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, P.R. China
| | - Jun Liao
- Department of Organ Transplantation, Zhujiang Hospital of Southern Medical University, Guangzhou 510000, P.R. China
| | - Weian Zhao
- Department of Anesthesiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, P.R. China
| | - Wenqi Huang
- Department of Anesthesiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, P.R. China
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4
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Mendez NV, Raveh Y, Livingstone JJ, Ciancio G, Guerra G, Burke III GW, Shatz VB, Souki FG, Chen LJ, Morsi M, Figueiro JM, Ibrahim TM, DeFaria WL, Nicolau-Raducu R. Perioperative risk factors associated with delayed graft function following deceased donor kidney transplantation: A retrospective, single center study. World J Transplant 2021; 11:114-128. [PMID: 33954089 PMCID: PMC8058644 DOI: 10.5500/wjt.v11.i4.114] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 02/05/2021] [Accepted: 03/11/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND There is an abundant need to increase the availability of deceased donor kidney transplantation (DDKT) to address the high incidence of kidney failure. Challenges exist in the utilization of higher risk donor organs into what appears to be increasingly complex recipients; thus the identification of modifiable risk factors associated with poor outcomes is paramount.
AIM To identify risk factors associated with delayed graft function (DGF).
METHODS Consecutive adults undergoing DDKT between January 2016 and July 2017 were identified with a study population of 294 patients. The primary outcome was the occurrence of DGF.
RESULTS The incidence of DGF was 27%. Under logistic regression, eight independent risk factors for DGF were identified including recipient body mass index ≥ 30 kg/m2, baseline mean arterial pressure < 110 mmHg, intraoperative phenylephrine administration, cold storage time ≥ 16 h, donation after cardiac death, donor history of coronary artery disease, donor terminal creatinine ≥ 1.9 mg/dL, and a hypothermic machine perfusion (HMP) pump resistance ≥ 0.23 mmHg/mL/min.
CONCLUSION We delineate the association between DGF and recipient characteristics of pre-induction mean arterial pressure below 110 mmHg, metabolic syndrome, donor-specific risk factors, HMP pump parameters, and intraoperative use of phenylephrine.
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Affiliation(s)
- Nicholas V Mendez
- Department of Anesthesiology, University of Miami/Jackson Memorial Hospital, Miami, FL 33136, United States
| | - Yehuda Raveh
- Department of Anesthesiology, University of Miami/Jackson Memorial Hospital, Miami, FL 33136, United States
| | - Joshua J Livingstone
- Department of Anesthesiology, University of Miami/Jackson Memorial Hospital, Miami, FL 33136, United States
| | - Gaetano Ciancio
- Department of Surgery, Miami Transplant Institute/University of Miami/Jackson Memorial Hospital, Miami, FL 33136, United States
| | - Giselle Guerra
- Division of Nephrology of the Department of Medicine, University of Miami/Jackson Memorial Hospital, Miami, FL 33136, United States
| | - George W Burke III
- Department of Surgery, Miami Transplant Institute/University of Miami/Jackson Memorial Hospital, Miami, FL 33136, United States
| | - Vadim B Shatz
- Department of Anesthesiology, University of Miami/Jackson Memorial Hospital, Miami, FL 33136, United States
| | - Fouad G Souki
- Department of Anesthesiology, University of Miami/Jackson Memorial Hospital, Miami, FL 33136, United States
| | - Linda J Chen
- Department of Surgery, Miami Transplant Institute/University of Miami/Jackson Memorial Hospital, Miami, FL 33136, United States
| | - Mahmoud Morsi
- Department of Surgery, Miami Transplant Institute/University of Miami/Jackson Memorial Hospital, Miami, FL 33136, United States
| | - Jose M Figueiro
- Department of Surgery, Miami Transplant Institute/University of Miami/Jackson Memorial Hospital, Miami, FL 33136, United States
| | - Tony M Ibrahim
- Department of Surgery, Miami Transplant Institute/University of Miami/Jackson Memorial Hospital, Miami, FL 33136, United States
| | - Werviston L DeFaria
- Department of Surgery, Miami Transplant Institute/University of Miami/Jackson Memorial Hospital, Miami, FL 33136, United States
| | - Ramona Nicolau-Raducu
- Department of Anesthesiology, University of Miami/Jackson Memorial Hospital, Miami, FL 33136, United States
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Dolla C, Mella A, Vigilante G, Fop F, Allesina A, Presta R, Verri A, Gontero P, Gobbi F, Balagna R, Giraudi R, Biancone L. Recipient pre-existing chronic hypotension is associated with delayed graft function and inferior graft survival in kidney transplantation from elderly donors. PLoS One 2021; 16:e0249552. [PMID: 33819285 PMCID: PMC8021200 DOI: 10.1371/journal.pone.0249552] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 03/20/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Pre-existing chronic hypotension affects a percentage of kidney transplanted patients (KTs). Although a relationship with delayed graft function (DGF) has been hypothesized, available data are still scarce and inconclusive. METHODS A monocentric retrospective observational study was performed on 1127 consecutive KTs from brain death donors over 11 years (2003-2013), classified according to their pre-transplant Mean Blood Pressure (MBP) as hypotensive (MBP < 80 mmHg) or normal-hypertensive (MBP ≥ 80 mmHg, with or without effective antihypertensive therapy). RESULTS Univariate analysis showed that a pre-existing hypotension is associated to DGF occurrence (p<0.01; OR for KTs with MBP < 80 mmHg, 4.5; 95% confidence interval [CI], 2.7 to 7.5). Chronic hypotension remained a major predictive factor for DGF development in the logistic regression model adjusted for all DGF determinants. Adjunctive evaluations on paired grafts performed in two different recipients (one hypotensive and the other one normal-hypertensive) confirmed this assumption. Although graft survival was only associated with DGF but not with chronic hypotension in the overall population, stratification according to donor age revealed that death-censored graft survival was significantly lower in hypotensive patients who received a KT from >50 years old donor. CONCLUSIONS Our findings suggest that pre-existing recipient hypotension, and the subsequent hypotension-related DGF, could be considered a significant detrimental factor, especially when elderly donors are involved in the transplant procedure.
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Affiliation(s)
- Caterina Dolla
- Renal Transplant Center “A. Vercellone,” Nephrology, Dialysis, and Renal Transplant Division, Department of Medical Sciences, “AOU Città Della Salute e Della Scienza di Torino” University Hospital, University of Turin, Turin, Italy
| | - Alberto Mella
- Renal Transplant Center “A. Vercellone,” Nephrology, Dialysis, and Renal Transplant Division, Department of Medical Sciences, “AOU Città Della Salute e Della Scienza di Torino” University Hospital, University of Turin, Turin, Italy
| | - Giacinta Vigilante
- Renal Transplant Center “A. Vercellone,” Nephrology, Dialysis, and Renal Transplant Division, Department of Medical Sciences, “AOU Città Della Salute e Della Scienza di Torino” University Hospital, University of Turin, Turin, Italy
| | - Fabrizio Fop
- Renal Transplant Center “A. Vercellone,” Nephrology, Dialysis, and Renal Transplant Division, Department of Medical Sciences, “AOU Città Della Salute e Della Scienza di Torino” University Hospital, University of Turin, Turin, Italy
| | - Anna Allesina
- Renal Transplant Center “A. Vercellone,” Nephrology, Dialysis, and Renal Transplant Division, Department of Medical Sciences, “AOU Città Della Salute e Della Scienza di Torino” University Hospital, University of Turin, Turin, Italy
| | - Roberto Presta
- Renal Transplant Center “A. Vercellone,” Nephrology, Dialysis, and Renal Transplant Division, Department of Medical Sciences, “AOU Città Della Salute e Della Scienza di Torino” University Hospital, University of Turin, Turin, Italy
| | - Aldo Verri
- Department of Vascular Surgery, “AOU Città Della Salute e Della Scienza” Hospital, University of Turin, Turin, Italy
| | - Paolo Gontero
- Department of Urology, "AOU Città della Salute e della Scienza” Hospital, University of Turin, Turin, Italy
| | - Fabio Gobbi
- Department of Anesthesia, Intensive Care and Emergency, “AOU Città Della Salute e Della Scienza” Hospital, University of Turin, Turin, Italy
| | - Roberto Balagna
- Department of Anesthesia, Intensive Care and Emergency, “AOU Città Della Salute e Della Scienza” Hospital, University of Turin, Turin, Italy
| | - Roberta Giraudi
- Renal Transplant Center “A. Vercellone,” Nephrology, Dialysis, and Renal Transplant Division, Department of Medical Sciences, “AOU Città Della Salute e Della Scienza di Torino” University Hospital, University of Turin, Turin, Italy
| | - Luigi Biancone
- Renal Transplant Center “A. Vercellone,” Nephrology, Dialysis, and Renal Transplant Division, Department of Medical Sciences, “AOU Città Della Salute e Della Scienza di Torino” University Hospital, University of Turin, Turin, Italy
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Eleftheriadis T, Pissas G, Crespo M, Nikolaou E, Liakopoulos V, Stefanidis I. A Role for Human Renal Tubular Epithelial Cells in Direct Allo-Recognition by CD4+ T-Cells and the Effect of Ischemia-Reperfusion. Int J Mol Sci 2021; 22:1733. [PMID: 33572206 PMCID: PMC7915934 DOI: 10.3390/ijms22041733] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 02/03/2021] [Accepted: 02/06/2021] [Indexed: 02/08/2023] Open
Abstract
Direct allorecognition is the earliest and most potent immune response against a kidney allograft. Currently, it is thought that passenger donor professional antigen-presenting cells (APCs) are responsible. Further, many studies support that graft ischemia-reperfusion injury increases the probability of acute rejection. We evaluated the possible role of primary human proximal renal tubular epithelial cells (RPTECs) in direct allorecognition by CD4+ T-cells and the effect of anoxia-reoxygenation. In cell culture, we detected that RPTECs express all the required molecules for CD4+ T-cell activation (HLA-DR, CD80, and ICAM-1). Anoxia-reoxygenation decreased HLA-DR and CD80 but increased ICAM-1. Following this, RPTECs were co-cultured with alloreactive CD4+ T-cells. In T-cells, zeta chain phosphorylation and c-Myc increased, indicating activation of T-cell receptor and co-stimulation signal transduction pathways, respectively. T-cell proliferation assessed with bromodeoxyuridine assay and with the marker Ki-67 increased. Previous culture of RPTECs under anoxia raised all the above parameters in T-cells. FOXP3 remained unaffected in all cases, signifying that proliferating T-cells were not differentiated towards a regulatory phenotype. Our results support that direct allorecognition may be mediated by RPTECs even in the absence of donor-derived professional APCs. Also, ischemia-reperfusion injury of the graft may enhance the above capacity of RPTECs, increasing the possibility of acute rejection.
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Affiliation(s)
- Theodoros Eleftheriadis
- Department of Nephrology, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece; (G.P.); (E.N.); (V.L.); (I.S.)
| | - Georgios Pissas
- Department of Nephrology, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece; (G.P.); (E.N.); (V.L.); (I.S.)
| | - Marta Crespo
- Nephrology Department, Institut Hospital del Mar d’Investigacions Mèdiques, Hospital del Mar, Parc de Salut Mar, 08003 Barcelona, Spain;
| | - Evdokia Nikolaou
- Department of Nephrology, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece; (G.P.); (E.N.); (V.L.); (I.S.)
| | - Vassilios Liakopoulos
- Department of Nephrology, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece; (G.P.); (E.N.); (V.L.); (I.S.)
| | - Ioannis Stefanidis
- Department of Nephrology, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece; (G.P.); (E.N.); (V.L.); (I.S.)
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7
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Scantlebery AM, Tammaro A, Mills JD, Rampanelli E, Kors L, Teske GJ, Butter LM, Liebisch G, Schmitz G, Florquin S, Leemans JC, Roelofs JJ. The dysregulation of metabolic pathways and induction of the pentose phosphate pathway in renal ischaemia-reperfusion injury. J Pathol 2021; 253:404-414. [PMID: 33338266 PMCID: PMC7986929 DOI: 10.1002/path.5605] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 12/01/2020] [Accepted: 12/14/2020] [Indexed: 02/06/2023]
Abstract
Lipid accumulation is associated with various forms of acute renal injury; however, the causative factors and pathways underpinning this lipid accumulation have not been thoroughly investigated. In this study, we performed lipidomic profiling of renal tissue following ischaemia–reperfusion injury (IRI). We identified a significant accumulation of cholesterol and specific phospholipids and sphingolipids in kidneys 24 h after IRI. In light of these findings, we hypothesised that pathways involved in lipid metabolism may also be altered. Through the analysis of published microarray data, generated from sham and ischaemic kidneys, we identified nephron‐specific metabolic pathways affected by IRI and validated these findings in ischaemic renal tissue. In silico analysis revealed the downregulation of several energy and lipid metabolism pathways, including mitochondrial fatty acid beta‐oxidation (FAO), peroxisomal lipid metabolism, fatty acid (FA) metabolism, and glycolysis. The pentose phosphate pathway (PPP), which is fuelled by glycolysis, was the only metabolic pathway that was upregulated 24 h following IRI. In this study, we describe the effect of renal IRI on metabolic pathways and how this contributes to lipid accumulation. © 2020 The Authors. The Journal of Pathology published by John Wiley & Sons, Ltd. on behalf of The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Angelique Ml Scantlebery
- Department of Pathology, Amsterdam Infection and Immunity Institute, Amsterdam University Medical Center (Location AMC), Amsterdam, The Netherlands
| | - Alessandra Tammaro
- Department of Pathology, Amsterdam Infection and Immunity Institute, Amsterdam University Medical Center (Location AMC), Amsterdam, The Netherlands
| | - James D Mills
- Department of Pathology, Amsterdam Infection and Immunity Institute, Amsterdam University Medical Center (Location AMC), Amsterdam, The Netherlands
| | - Elena Rampanelli
- Department of Experimental Vascular Medicine, Amsterdam University Medical Center (Location AMC), Amsterdam, The Netherlands
| | - Lotte Kors
- Department of Pathology, Amsterdam Infection and Immunity Institute, Amsterdam University Medical Center (Location AMC), Amsterdam, The Netherlands
| | - Gwendoline J Teske
- Department of Pathology, Amsterdam Infection and Immunity Institute, Amsterdam University Medical Center (Location AMC), Amsterdam, The Netherlands
| | - Loes M Butter
- Department of Pathology, Amsterdam Infection and Immunity Institute, Amsterdam University Medical Center (Location AMC), Amsterdam, The Netherlands
| | - Gerhard Liebisch
- Institute of Clinical Chemistry and Laboratory Medicine, University Hospital of Regensburg, Regensburg, Germany
| | - Gerd Schmitz
- Institute of Clinical Chemistry and Laboratory Medicine, University Hospital of Regensburg, Regensburg, Germany
| | - Sandrine Florquin
- Department of Pathology, Amsterdam Infection and Immunity Institute, Amsterdam University Medical Center (Location AMC), Amsterdam, The Netherlands
| | - Jaklien C Leemans
- Department of Pathology, Amsterdam Infection and Immunity Institute, Amsterdam University Medical Center (Location AMC), Amsterdam, The Netherlands
| | - Joris Jth Roelofs
- Department of Pathology, Amsterdam Infection and Immunity Institute, Amsterdam University Medical Center (Location AMC), Amsterdam, The Netherlands.,Amsterdam Cardiovascular Sciences, Amsterdam University Medical Center (Location AMC), Amsterdam, The Netherlands
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Cayetano-Alcaraz A, Rodriguez-Alvarez JS, Vilatobá-Chapa M, Alberú-Gómez J, Gabilondo-Pliego B, Rodríguez-Covarrubias F, Morales-Buenrostro LE, Méndez-Probst CE. Is delayed graft function associated with ureteral stenosis in the kidney transplant recipient? A case-control study. Can Urol Assoc J 2019; 13:E361-E365. [PMID: 30817285 DOI: 10.5489/cuaj.5794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Ureteral stricture (US) in the kidney transplant recipient is a rare complication that can lead to morbidity and graft loss. Risk factor recognition is crucial in the prevention and management of this entity. Delayed graft function (DGF), as defined by the need for dialysis in the first week after transplantation, has been proposed as a risk factor in previous studies. Our objective is to determine the impact of DGF in US development in kidney transplant patients. METHODS We designed a matched case-control study. US cases in kidney transplant recipients were identified in the 2008-2017 period. We defined US as the rise in serum creatinine associated with findings suggesting obstruction in ultrasound, scintigraphy, or retrograde pyelogram; any other cause of graft dysfunction was excluded. Controls were defined as kidney transplant recipients from the same population and period without US, matched in a 1:2 fashion by age, sex, and donor type. RESULTS From 532 kidney transplant patients, 31 cases and 62 controls were included. Cumulative US incidence was 58 per 1000 cases. When calculating for odds ratio (OR), post-operative urinoma (OR 3.2; 95% confidence interval [CI] 2.36-4.37) and ureteral duplication (OR 3.29; 95% CI 2.40-4.51) were associated with an increased risk for US, while DGF was not found to be statistically significant as a risk factor (OR 3.3; 95% CI 0.96-11.52). No statistically significant differences were found between groups in other pre- and post-transplant-related factors CONCLUSIONS:: DGF was not associated with US in our cohort; however, ureteral duplication and postoperative urinoma were associated with an increased risk of graft ureteral stenosis development.
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Affiliation(s)
- Axel Cayetano-Alcaraz
- Department of Urology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Mario Vilatobá-Chapa
- Department of Transplants, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Josefina Alberú-Gómez
- Department of Transplants, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Bernardo Gabilondo-Pliego
- Department of Urology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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Factors Associated With Delayed Graft Function and Their Influence on Outcomes of Kidney Transplantation. Transplant Proc 2017; 48:2267-2271. [PMID: 27742276 DOI: 10.1016/j.transproceed.2016.06.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND One of the main postoperative complications of kidney transplant is delayed graft function (DGF), which means absence of graft function after transplant or the need for dialysis during the first week post procedure. The occurrence of DGF currently in our hospital is high and has been attributed to a combination of many factors. The aim of this study was to evaluate the factors associated to DGF and their influence in the outcome of kidney transplants. METHODS Historical cohort of 150 patients transplanted with live or deceased donor kidneys from 2011 to 2013. RESULTS DGF was associated to time in dialysis and the number of recipient pre-transplant transfusions, donors age, serum creatinine level, use of vasoactive drugs in the donor, distance from place of organ retrieval and transplant center, and duration of cold ischemia time. DGF influenced post-transplantation outcome in regard to length of stay in intensive care, length of hospital stay, acute rejection episodes, and higher creatinine levels at discharge. Patients and graft survival were shorter in the DGF group. CONCLUSIONS There are multiple factors related to DGF, the most important being those related to donors, and organ storage. The most important factor related to the recipient was the dialysis vintage. We did not find a correlation between DGF and HLA-compatibility. DGF consequences are important, including worse graft function and survival, as well as impact in recipient morbidity and mortality.
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Sampaio TL, Menezes RRPPBD, da Costa MFB, Meneses GC, Arrieta MCV, Chaves Filho AJM, de Morais GB, Libório AB, Alves RS, Evangelista JSAM, Martins AMC. Nephroprotective effects of (-)-α-bisabolol against ischemic-reperfusion acute kidney injury. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2016; 23:1843-1852. [PMID: 27912887 DOI: 10.1016/j.phymed.2016.11.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 10/28/2016] [Accepted: 11/10/2016] [Indexed: 05/14/2023]
Abstract
BACKGROUND Ischemia/reperfusion (I/R) in kidney is commonly related to acute kidney injury (AKI), essentially through oxidative stress. (-)-α-Bisabolol is a sesquiterpene isolated from the essential oil of a variety of plants, including chamomile, which has important antioxidant activity. STUDY DESIGN This study intends to evaluate the nephroprotective activity of (-)-α-bisabolol (Bis) in both in vivo and in vitro models of kidney I/R. METHODS Male Wistar rats were submitted to right nephrectomy, followed by ischemia by clamping of the renal artery in the left kidney for 60min. and 48h of reperfusion. The animals were treated orally with Bis (100mg/kg) or vehicle for 24h after reperfusion, and placed in metabolic cages, to evaluate water consumption, diuresis, urinary osmolality, classic biochemical markers and urinary KIM-1 (kidney injury molecule-1). Additionally, the left kidney was collected for histological evaluation and determination of glutathione (GSH) and Thiobarbituric Acid Reactive Substances (TBARS) levels. Tubular epithelial cells LLC-MK2 were used to assess Bis effect on in vitro I/R, by MTT assay. It was performed the cellular respiration tests by flow cytometry: evaluation of the production of cytoplasmic reactive oxygen species by DCFH-DA assay and mitochondrial transmembrane potential analysis with the dye rhodamine 123. RESULTS I/R caused alterations in diuresis, water intake, urinary osmolality, plasmatic creatinine, urea and uric acid, creatinine clearance, proteinuria and microalbuminuria. Treatment with Bis ameliorated all of these parameters. Also, KIM-1 level enhanced by I/R was also diminished in groups treated with Bis. The histological examination showed that Bis attenuated the morphological changes caused by I/R, markedly vascular congestion and intratubular deposits of proteinaceous material. Additionally, Bis was able to reduce the changes observed in TBARS and GSH levels in kidney tissue. In in vitro assay, Bis was capable to partially protect the cell lineage against cell damage induced by I/R. CONCLUSION (-)-α-Bisabolol has a nephroprotective effect in kidney I/R, with antioxidant effect. Moreover, this result seems to be associated to a direct protective effect on tubular epithelia.
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Affiliation(s)
- Tiago Lima Sampaio
- Department of Physiology and Pharmacology, School of Medicine, Federal University of Ceará, Ceará, Brazil
| | | | | | | | | | | | | | - Alexandre Braga Libório
- Department of Clinical Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceara, Brazil
| | - Renata Sousa Alves
- Department of Clinical and Toxicological Analysis, School of Pharmacy, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | | | - Alice Maria Costa Martins
- Department of Clinical and Toxicological Analysis, School of Pharmacy, Federal University of Ceará, Fortaleza, Ceará, Brazil
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Fractal analysis and Gray level co-occurrence matrix method for evaluation of reperfusion injury in kidney medulla. J Theor Biol 2016; 397:61-7. [DOI: 10.1016/j.jtbi.2016.02.038] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 01/30/2016] [Accepted: 02/28/2016] [Indexed: 11/18/2022]
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12
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Tripterysium glycosides preconditioning attenuates renal ischemia/reperfusion injury in a rat model. Int Urol Nephrol 2015; 48:213-21. [DOI: 10.1007/s11255-015-1160-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 11/03/2015] [Indexed: 10/22/2022]
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. EXP CLIN TRANSPLANT 2015; 13. [DOI: 10.6002/ect.2015.0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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14
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Seo CH, Ju JI, Kim MH, Jun KW, Ahn SH, Hwang JK, Kim SD, Park SC, Choi BS, Kim JI, Yang CW, Kim YS, Moon IS. Risk factors and long-term outcomes of delayed graft function in deceased donor renal transplantation. Ann Surg Treat Res 2015; 89:208-14. [PMID: 26446498 PMCID: PMC4595821 DOI: 10.4174/astr.2015.89.4.208] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 04/15/2015] [Accepted: 05/06/2015] [Indexed: 11/30/2022] Open
Abstract
Purpose The purpose of this study was to analyze the risk factors for delayed graft function (DGF) and determine its impact on the outcomes of deceased donor (DD) kidney transplantation (KT). Methods Between January 2000 and December 2011, we performed 195 DD renal transplants. After the exclusion of primary nonfunctional grafts (n = 4), the study recipients were divided into two groups-group I, DGF (n = 31, 16.2%); group II, non-DGF (n = 160, 83.8%). The following variables were compared: donor and recipient characteristics, patient and graft survival, postoperative renal function, acute rejection (AR) episodes, and the rates of surgical and infectious complications. Results Donor-related variables that showed significant differences included hypertension (P = 0.042), diabetes (P = 0.025), and prerecovery serum creatinine levels (P < 0.001). However, there were no significant differences in recipient-related factors. One significantly different transplant-related factor was positive panel reactive antibody (PRA > 20%, P = 0.008). On multivariate analysis, only the prerecovery serum creatinine level (P < 0.001; hazard ratio [HR], 1.814) was an independent risk factor for the development of DGF. A Cox multivariate analysis of risk factors for graft survival identified these independent risk factors for graft survival: nephron mass (donor kidney weight to recipient body weight ratio) index (P = 0.026; HR, 2.328), CMV infection (P = 0.038; HR, 0.114), and AR episode (P = 0.038; HR, 0.166). Conclusion In DD KT, an independent risk factor for DGF was the prerecovery serum creatinine level. Although there was a significant difference in graft survival between the DGF and non-DGF groups, DGF was not an independent risk factor for graft failure in this study.
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Affiliation(s)
- Chang Ho Seo
- Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jeong Il Ju
- Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Mi-Hyeong Kim
- Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Kang Woong Jun
- Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Sang-Hyun Ahn
- Department of Surgery, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jeong Kye Hwang
- Department of Surgery, Daejeon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Daejeon, Korea
| | - Sang Dong Kim
- Department of Surgery, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea
| | - Sun Cheol Park
- Department of Surgery, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu, Korea
| | - Bum Soon Choi
- Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Ji Il Kim
- Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Chul Woo Yang
- Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Yong Soo Kim
- Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - In Sung Moon
- Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
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da Costa MFB, Libório AB, Teles F, Martins CDS, Soares PMG, Meneses GC, Rodrigues FADP, Leal LKAM, Miron D, Silva AH, Martins AMC. Red propolis ameliorates ischemic-reperfusion acute kidney injury. PHYTOMEDICINE 2015; 22:787-795. [DOI: 10.1016/j.phymed.2015.03.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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Merter AA, Mayir B, Erdogan O, Colak T. Protective effects of amifostine on ischemia-reperfusion injury of rat kidneys. Indian J Pharmacol 2015; 47:185-189. [PMID: 25878379 PMCID: PMC4386128 DOI: 10.4103/0253-7613.153427] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 01/02/2015] [Accepted: 02/22/2015] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES Amifostine is a drug which can eliminate free oxygen radicals that appear in the body after radiation or chemotherapeutic agent exposure. It is used to decrease the renal toxicity of cisplatin. The aim of this study was to determine the role of amifostine in warm ischemia kidney model for prevention of ischemia/reperfusion injury and also to find out the mechanism for prevention from ischemia/reperfusion injury if such an effect does exist. MATERIALS AND METHODS Adult female rats (n = 40) that used in our study were divided into three groups. Group 1: Control (n = 8), group 2: Ischemia-control (n = 16), group 3: Amifostine treated (n = 16). The effect of amifostine on ischemia/reperfusion injury investigated in rat kidneys. RESULTS At the 7(th) day, blood urea nitrogen level was statistically significantly higher in ischemia-control group than all groups (P = 0.001) and mean serum creatinine levels were found to be the highest in ischemia-control group (P = 0.091). Mean malondialdehyde levels in left kidneys removed on the 7(th) day were not significantly different (P = 0.105) at all three groups. Between ischemia-control group and amifostine group, there was a significant difference in reduced glutathione (GSH) levels (P = 0.001). In amifostine group, grade 4 necrosis was not detected neither on 7(th) day nor day 0. CONCLUSION Amifostine could decrease the degree and severity of necrosis after reperfusion. Amifostine could not prevent membrane lipid peroxidation caused by superoxide anion radicals in kidney but they could protect tissues from the harmful effects of ischemia/reperfusion injury by increasing the level of reduced GSH which is a well-known oxygen radical eliminator.
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Affiliation(s)
- Ayse Arducoglu Merter
- Department of General Surgery, Antalya Training and Research Hospital, Antalya, Turkey
| | - Burhan Mayir
- Department of General Surgery, Antalya Training and Research Hospital, Antalya, Turkey
| | - Okan Erdogan
- Department of General Surgery, Akdeniz University, School of Medicine, Antalya, Turkey
| | - Taner Colak
- Department of General Surgery, Akdeniz University, School of Medicine, Antalya, Turkey
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Urine--a waste or the future of regenerative medicine? Med Hypotheses 2015; 84:344-9. [PMID: 25649852 DOI: 10.1016/j.mehy.2015.01.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 09/19/2014] [Accepted: 01/15/2015] [Indexed: 02/07/2023]
Abstract
In recent years, urine has emerged as a source of urine cells. Two different types of cells can be isolated from urine: urine derived stem cells (USCs) and renal tubular cells called urine cells (UCs). USCs have great differentiation properties and can be potentially used in genitourinary tract regeneration. Within this paper, we attempt to demonstrate that such as easily accessible source of cells, collected during completely non-invasive procedures, can be better utilized. Cells derived from urine can be isolated, stored, and used for the creation of urine stem cell banks. In the future, urine holds great potential to become a main source of cells for tissue engineering and regenerative medicine.
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