Effects of PUVA therapy on kidney allografts: results of a randomized prospective double-blind study

Abstract

After successful experimental organ transplant studies on the efficacy of PUVA therapy combining donor pretreatment with the photosensitizer 8-methoxypsoralen (P) and the ex vivo irradiation of organs with long-wave ultraviolet light (UVA) prior to transplantation, we started in 1989 the first randomized, prospective, double-blind study to clarify the efficacy of PUVA therapy in human kidney transplantation. This study included 50 kidney donors, 25 of whom were PUVA-treated. A total of 75 kidneys were transplanted in Berlin, Halle and Rostock. The complete data of these 75 recipients were available for the final evaluation. The PUVA group (n = 36) and the non-PUVA group (n = 39) were not statistically significantly different as to donor and recipient data. Regarding the results, no differences were seen in initial hospitalization time, early graft function, rejection rate, number and time of rejection episodes. After a follow-up of 24 months, both graft survival (PUVA vs. non-PUVA: 75% vs. 71.8%) and patient survival (97.2% vs. 97.4%, respectively) were comparably high. PUVA therapy did not influence the development of vascular rejection. Interestingly, the rate of late graft loss after the 6th posttransplant month was lower, but not statistically significantly so, in the PUVA than in the non-PUVA-group (2 vs. 6 graft losses). Thus, PUVA-pretreated kidneys may be associated with a reduced development of chronic rejection.

Identification of novel indicators of cyclosporine A nephrotoxicity in a CD-1 mouse model

“…The biological role of Tamm-Horsfall protein is unclear, however decreased urinary Tamm-Horsfall protein is considered an indicator of tubular damage and has been proposed as a biomarker in other forms of renal disease (Kistler et al, 2009;Prajczer et al, 2010). Urinary Tamm-Horsfall protein levels have previously been proposed as an indicator of renal function in transplant recipients (Kaden et al, 1994) and the results of this study suggest that urinary uromodulin levels may also be an indicator of CsA nephrotoxicity.…”