Renal Transplantation

Future strategies to improve short- and long-term outcomes of renal transplantation in dogs

“…In transplantion cases, MHC is considered important because the principal targets of the immune response are the MHC molecules expressed on the surface of donor cells, which causes graft rejection (AYALA GARCÍA et al 2012). Pharmacologic interventions that reduce T-cell and B-cell activation can prevent allograft rejection (ADIN, 2011;SHIN et al, 2019).…”

“…MHC has now been characterized in several species, especially mammals, and are given specific names, such as dog leukocyte antigen (DLA), feline leukocyte antigen (FLA), and the human leukocyte antigen (HLA) (ADIN, 2011;BUENTJEN et al, 2015).…”

“…Four discrete DLA genes have been identified in dogs and each dog has a total of eight genes (four from each parent), making the level of genetic diversity quite high (ADIN, 2011;MIYAMAE et al, 2018). For these reasons, most efforts at transplantation in dogs with naturally occurring renal disease have been focused on achieving successful immunosuppression in nontissue-matched renal transplant recipients.…”

“…The recipient of a kidney transplant requires immune system suppression for the rest of their life; so the common goal of dog transplant strategies is preventing allograft rejection with minimal drug nephrotoxicity and reducing the cost of immunosupression (ADIN, 2006, ADIN, 2011. These strategies have included dose reduction and combination with other drugs.…”

“…Although medical management may be initially effective in stabilizing a patient, it is not sufficient to maintain a patient with end-stage renal disease (ESRD) (ARONSON, 2016). Kidney transplantation, which is an established treatment for human patients, is now considered the treatment of choice in cats since it offers prolonged survival and improved quality of life compared to medical management and dialysis (ADIN, 2011;TATAPUDI & MONTGOMERY, 2017).…”