Assessment of renal graft function by perioperative monitoring of cortical microcirculation in kidney transplantation.1

Angelescu, M; Kraus, Thomas; Wiesel, M.; Hergesell, Olaf; Haberkorn, Uwe; Klar, E.

doi:10.1097/01.tp.0000061600.74982.0d

Cited by 27 publications

(24 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Microcirculation is a characteristic parameter of organ function and viability as already demonstrated by Anelescu and colleagues, who showed that microcirculatory derangements after reperfusion in the kidney correlate with impaired graft function after transplantation 30. Indeed, combining the deleterious effects of BD and IRI, microcirculation assessed by IVFM was dramatically impaired when organs from BD donors were transplanted and reperfused for 2 h as compared to naïve or sham control animals (Figure 2B and C).…”

Section: Discussionsupporting

confidence: 61%

Treatment With Tetrahydrobiopterin Overcomes Brain Death–Associated Injury in a Murine Model of Pancreas Transplantation

Oberhuber

Ritschl

Fabritius

et al. 2015

American Journal of Transplantation

View full text Add to dashboard Cite

Brain death (BD) has been associated with an immunological priming of donor organs and is thought to exacerbate ischemia reperfusion injury (IRI). Recently, we showed that the essential nitric oxide synthase co‐factor tetrahydrobiopterin (BH4) abrogates IRI following experimental pancreas transplantation. We therefore studied the effects of BD in a murine model of syngeneic pancreas transplantation and tested the therapeutic potential of BH4 treatment. Compared with sham‐operated controls, donor BD resulted in intragraft inflammation reflected by induced IL‐1ß, IL‐6, VCAM‐1, and P‐selectin mRNA expression levels and impaired microcirculation after reperfusion (p < 0.05), whereas pretreatment of the BD donor with BH4 significantly improved microcirculation after reperfusion (p < 0.05). Moreover, BD had a devastating impact on cell viability, whereas BH4‐treated grafts showed a significantly higher percentage of viable cells (p < 0.001). Early parenchymal damage in pancreatic grafts was significantly more pronounced in organs from BD donors than from sham or non‐BD donors (p < 0.05), but BH4 pretreatment significantly ameliorated necrotic lesions in BD organs (p < 0.05). Pretreatment of the BD donor with BH4 resulted in significant recipient survival (p < 0.05). Our data provide novel insights into the impact of BD on pancreatic isografts, further demonstrating the potential of donor pretreatment strategies including BH4 for preventing BD‐associated injury after transplantation.

show abstract

Section: Discussionsupporting

confidence: 61%

Treatment With Tetrahydrobiopterin Overcomes Brain Death–Associated Injury in a Murine Model of Pancreas Transplantation

Oberhuber

Ritschl

Fabritius

et al. 2015

American Journal of Transplantation

View full text Add to dashboard Cite

show abstract

“…Macrocirculation can decisively influence microcirculation, which itself is a determining factor in organ quality and graft viability. Anelescu and colleagues could show that microcirculatory derangements after reperfusion in the kidney correlate with impaired graft function after transplantation (19). The same group demonstrated the importance of microcirculatory events in predicting primary graft failure by intraoperative quantification of liver perfusion (20).…”

Section: Discussionmentioning

confidence: 99%

Brain Death Impairs Pancreatic Microcirculation

Obermaier

Dobschuetz

Keck

et al. 2004

American Journal of Transplantation

View full text Add to dashboard Cite

Brain death (BD) influences the quality of donor grafts in transplantation. To evaluate the impact of BD on pancreas grafts, we investigated the influence of BD on the microcirculation and histology of the pancreas in a rat model of explosive BD. A group of Wistar rats (n = = 7), rendered brain dead by inflating an intracranially inserted Fogarty catheter was compared with controls (CO) using intravital epifluorescence-microscopy over 4 h after BD induction; functional capillary density (FCD), leukocyte adherence (AL) in post-capillary venules, histology and pancreatic enzymes were investigated. Four hours after BD, FCD decreased (333 ± 11 vs. baseline 444 cm/cm 2 ± 5 SEM; p < 0.01) and showed lower values than CO (388 ± 9 p < 0.01). In BD, AL was increased (628 cells/mm 2 ± 110 SEM vs. baseline 123 ± 32, and vs. CO 180 ± 33; p < 0.001). BD caused increased histological damage (CO 1.6 scorepoints ± 0.7 SD vs. BD 8.3 ± 7.1; p < 0.05). Amylase was higher in BD (p < 0.05) but did not reach pathological values. We show for the first time that BD causes relevant changes in pancreatic microcirculation, histology and leukocyte endothelial interaction which might have a serious impact on the function of grafts. New strategies for preventing this damage are therefore highly desirable in order to improve the outcome of pancreas transplantation.

show abstract

“…The different perfusion intensities in different regions of the renal cortex suggest uneven distribution of resistance to renal microcirculation in DGF patients, which may be related to the pathological changes of terminal vasculature induced by ischemic reperfusion in the transplanted kidney (Inman et al, 2003;Huang et al, 2002). This may also be the mechanism of difference in the study by Angelescu et al (2003) (Figure 1). …”

Section: Discussionmentioning

confidence: 91%

“…Using a thermal dissipation probe inserted into the cortex of the transplanted kidney, Angelescu et al (2003) found lower microcirculatory perfusion in DGF patients than in patients with a normally functioning transplanted kidney. In addition, ischemic reperfusion has been shown to result in increased serum levels of endothelin and endothelin-1, but decreased levels of the vasodilator nitric oxide, which increases vascular resistance in the transplanted kidney (Schilling et al, 1996;Huang et al, 2002;Inman et al, 2003;Perico et al, 2004;Zlotnick et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Ultrasonic imaging characteristics of transplanted kidneys with delayed graft function

Liang¹,

Cai²,

Jiang³

et al. 2014

Genet. Mol. Res.

View full text Add to dashboard Cite

ABSTRACT. We investigated the ultrasonic imaging characteristics of transplanted kidneys with delayed graft function (DGF). Ultrasonography was performed in 44 patients after kidney transplantation, and a time-intensity analysis was performed to compare the differences between patients with normal graft function (NGF) and those with DGF. Compared with the NGF group, the DGF group had earlier arrival time, shorter time to peak, and higher arrival intensity and peak intensity (P < 0.05). The variation-ofintensity parameters in different renal cortices increased, whereas the variation-of-time parameter decreased, in those with DGF (P < 0.05). In conclusion, compared with the NGF group, the microcirculation perfusion of transplanted kidneys in the DGF group showed higher perfusion with earlier arrival time, shorter time to peak, and higher arrival intensity and peak intensity. In addition, the 6879 ©FUNPEC-RP www.funpecrp.com.br Genetics and Molecular Research 13 (3): 6878-6884 (2014) Ultrasonic imaging of delayed graft function intensity variations of contrast agent in different renal cortices from patients with DGF were greater, whereas the variations in perfusion time were smaller than those in patients with NGF.

show abstract

Assessment of renal graft function by perioperative monitoring of cortical microcirculation in kidney transplantation.1

Cited by 27 publications

References 25 publications

Treatment With Tetrahydrobiopterin Overcomes Brain Death–Associated Injury in a Murine Model of Pancreas Transplantation

Treatment With Tetrahydrobiopterin Overcomes Brain Death–Associated Injury in a Murine Model of Pancreas Transplantation

Brain Death Impairs Pancreatic Microcirculation

Ultrasonic imaging characteristics of transplanted kidneys with delayed graft function

Contact Info

Product

Resources

About