Living-donor and Deceased-donor Renal Transplantation: Differences in Early Outcome–A Single-center Experience

Guimarães, Joana; Araújo, A. M.; Santos, F; Nunes, Catarina S.; Casal, M. C.

doi:10.1016/j.transproceed.2015.03.008

Cited by 24 publications

(21 citation statements)

References 24 publications

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“…In particular, kidney tissue injury during ischemia/reperfusion comes as a result of membrane lipids peroxidation, oxidative damage of proteins and DNA, and it results in apoptosis and necrosis 41 . Previous studies have been developed considering the cold ischemia time like a predictor of cardiovascular, nephro-urologic, and endocrine complications 42 . The observed increase of e-GST activity is an indication of paramount relevance as most of these kidneys display normal morphological structure and thus e-GST may represents an innovative and very sensitive biomarker of kidney efficiency.…”

Section: Discussionmentioning

confidence: 99%

Erythrocyte glutathione transferase in kidney transplantation: a probe for kidney detoxification efficiency

et al. 2018

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Erythrocyte glutathione transferase (e-GST) is overexpressed in case of increased blood toxicity and its level correlates with the kidney disease progression. Thus, it represents a probe of kidney efficiency against circulating toxins. We measured the activity of e-GST in patients with transplant kidney from living and cadaver donors, correlated its level to biochemical parameters of kidney function, and measured the level of oxidized albumin as a probe of oxidative stress using a new simple procedure. Interestingly, the activity of e-GST in transplant patients from cadaver donors (N = 153) is very high (11.7 U/gHb) compared to healthy subjects (N = 80) ( 5.6 U/gHb). Lower values were observed in transplant patients with kidney from living donors (N = 16) (9.8 U/gHb). Except for steroids, no correlation has been found with the immunosuppressive therapies and routine clinical and laboratory parameters. Also serum oxidized albumin, which reveals oxidative stress, is significantly higher in transplant patients from cadaver donors (53%) compared to that from living donors (36%). Overall, these data indicate that most of transplant kidneys from cadavers lost part of the detoxifying power against circulating toxins and suffer a relevant oxidative stress compared to those coming from living donors. A case report suggests that e-GST could represent a very early marker of incipient graft rejection. In conclusion, e-GST may be used to check the decline or maintenance of the kidney detoxification competence during post-transplantation course.

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Section: Discussionmentioning

confidence: 99%

Erythrocyte glutathione transferase in kidney transplantation: a probe for kidney detoxification efficiency

et al. 2018

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“…27.5%). [32] In our study, more common cytopenia in deceased donor KT recipients may be related to more common use of rATG in these patients. rATG is used in some KT centers to decrease the dose of CNIs and risk of delayed graft function in kidney transplant recipients from deceased donors.…”

Section: Discussionmentioning

confidence: 69%

Cytopenia occurrence in kidney transplant recipients within early post-transplant period

et al. 2017

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Objective:This study assessed incidence, severity, and time to occurrence of drug-induced leukopenia/thrombocytopenia within 1st month after kidney transplantation.Methods:This cross-sectional study was conducted on newly kidney transplant recipients from two hospitals, Iran. Patients with thrombocytopenia due to acute antibody-mediated rejection were excluded from the study. Demographic, clinical, and laboratory data of patients within the 1st month after transplantation were collected.Findings:Of 213 patients, 14.1% and 66.2% experienced leukopenia and thrombocytopenia, respectively. Cytopenia happened more commonly among patients with thymoglobulin-containing regimen (for leukopenia: 24.6% vs. 0%, P < 0.001; for thrombocytopenia 84.4% vs. 41.8%, P < 0.001). Most leukopenia patients experienced Grades 1 and 2 of leukopenia (46.6% and 40% of patients). Most thrombocytopenic patients showed Grade 1 of thrombocytopenia (78.7%). Cumulative dose of thymoglobulin did not differ between patients with and without leukopenia (5.57 ± 1.13 vs. 5.9 ± 1.96 mg/kg; P = 0.613) or with and without thrombocytopenia (5.87 ± 1.86 vs. 5.56 ± 1.38 mg/kg; P = 0.29). Cytopenia were more common among recipients from deceased compared with from living donors (91.3% vs. 8.7% for leukopenia patients, P = 0.001; 69.9% vs. 33.1% for thrombocytopenia, P = 0.02). More patients with kidney from deceased donors received thymoglobulin in their immunosuppressive regimen (82% vs. 37%; P < 0.001). The median time to leukopenia and thrombocytopenia were 3 days and 1 day, respectively.Conclusion:Among immunosuppressive and prophylactic antimicrobial agents, thymoglobulin is more related to cytopenia; therefore, thymoglobulin dose reduction is recommended as the first intervention to manage cytopenia without need for reduction of its cumulative dose. The higher prevalence of cytopenia among recipients from deceased donors may be related to the higher use of thymoglobulin in these patients.

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“…In this pilot study, we aimed to characterise the miRNA and protein profiles of SEC-isolated uEVs from living and deceased kidney donors to profile the organ status before Kidney transplantation (KTx). Several factors account for the outcome of KTx, including those related to the characteristics of the donor [ 2 – 4 , 11 ]. Although one of the most important factors directly affecting KTx outcome is the time of cold ischemia, which is usually longer in DD organs, an additional factor to be considered is the status of the organ before the extraction.…”

Section: Discussionmentioning

confidence: 99%

“…Some of the most important parameters affecting patient’s survival after transplantation are related to age (of both donor and recipient), previous pathology of the recipient and the extent of the ischemia-reperfusion injury [ 4 , 6 – 8 ]. It is widely accepted, and strongly supported, that transplantation from LDs offers better long-term outcomes than deceased organ transplants [ 9 – 11 ]; because of DDs are usually older, have more comorbidities and longer cold ischemia time than LD [ 10 – 12 ]. Moreover, in order to maintain the organs in optimal conditions, hemodynamic stability, adequate oxygenation, the correction of hypothermia, diabetes insipidus and electrolyte disturbances should be corrected by drug administration [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Molecular profile of urine extracellular vesicles from normo-functional kidneys reveal minimal differences between living and deceased donors

et al. 2018

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BackgroundKidney transplantation (KTx) is the best therapeutic approach for chronic kidney diseases leading to irreversible kidney failure. Considering the origin of the graft, several studies have reported differences between living (LD) and deceased donors (DD) in graft and patient survival. These differences seem to be related to multiple factors including, donor age and time of cold ischemia among others. Many of transplanted organs come from old-aged DDs, in which pre-transplant biopsy is recommended. However, kidney biopsy has several limitations, and there is a need to develop alternatives to assess the status of a kidney before transplantation. As the analysis of urinary extracellular vesicles (uEVs) rendered promising results as non-invasive biomarkers of kidney-related pathologies, this pilot study aimed to investigate whether profiling uEVs of LDs and DDs may be of help to assess the quality of the kidney before nephrectomy.MethodsuEVs from 5 living donors and 7 deceased donors were isolated by size-exclusion chromatography, and their protein and miRNA content were analysed by liquid chromatography followed by mass spectrometry and next generation sequencing, respectively. Then, hierarchical clustering and venn diagrams were done with Perseus software and InteractiVenn tool. Specific EVs data bases were also used for Gene Ontology analysis.ResultsNext generation sequencing revealed that uEVs from DDs contained less miRNAs than LDs, but most of the DD-expressed miRNAs were shared with LDs (96%). Only miR-326 (targeting the apoptotic-related Bcl2) was found significantly over-represented in LD. Focusing on the protein content, we detected a low intra-group correlation in both types of donors. Despite these differences, hierarchical clustering of either miRNA or protein data could not identify a differential profile between LDs and DDs. Of note, 90% of transplanted patients had a functional graft after a year from KTx.ConclusionsIn this pilot study we found that, in normo-functional grafts, minor differences in uEVs profile could not discriminate between LDs and DDs.

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Living-donor and Deceased-donor Renal Transplantation: Differences in Early Outcome–A Single-center Experience

Cited by 24 publications

References 24 publications

Erythrocyte glutathione transferase in kidney transplantation: a probe for kidney detoxification efficiency

Erythrocyte glutathione transferase in kidney transplantation: a probe for kidney detoxification efficiency

Cytopenia occurrence in kidney transplant recipients within early post-transplant period

Molecular profile of urine extracellular vesicles from normo-functional kidneys reveal minimal differences between living and deceased donors

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