Remote Donor Preconditioning for Increasing Transplant Survival in the Recipient’s Body During the Kidney Transplantation From the Living-Related Donor

Abstract

The aim: To estimate the protective effect of remote ischemic preconditioning (RIPC) on kidney transplants harvested from living related donors. Materials and methods: To achieve the claimed aim, there were examined 60 donor-recipient couples, where kidney transplant donors were living-related. All donors had the same anaesthetic management. The first group (n = 30) received RIPC which included four procedures of cuff inflations each lasting 5 minutes followed by 5-minute intervals of cuff deflation to measure blood pressure up to 40 mm Hg above systolic blood pressure on the shoulder. Patients of the second group (controls) did not experience RIPC (n = 30) and control group without RIPC. Results: RIPC resulted in a statistically significant (P<0.05) increase in GFR of the transplanted kidney from 66±5 mL /min to 63±4 mL /min after 3 months, from 69±3 mL /min to 61±5 mL /min after 6 months, from 63±2.5 mL /min to 57±3 mL /min after 12 months; a 3-fold reduced partial delay of graft function; a 2-fold decreased incidence of acute kidney transplant rejection times; 1.5-fold decline in the incidence of primary non-function; and 1.4-fold tCr50 acceleration (p = 0.16). The follow-up period lasted for a year after transplantation. Conclusions: RIPC during organ harvesting improved graft ischemic protection and increased functioning efficiency in the recipient.

NGAL in the Development of Acute Kidney Injury in a Murine Model of Remote Ischaemic Preconditioning and Liver Ischaemia Reperfusion

“…The underlying mechanisms of protection remain poorly understood but involve neural, humoral and systemic pathways and include a downregulation of oxidative stress and upregulation of protective pathways within the transplant organ [19]. Whilst experimental animal models have provided promising results, there has been limited translation into clinical practice [20][21][22][23][24].…”