Early outcome in renal transplantation from large donors to small and size‐matched recipients – A porcine experimental model

Abstract

Kidney transplantation from a large donor to a small recipient, as in pediatric transplantation, is associated with an increased risk of thrombosis and DGF. We established a porcine model for renal transplantation from an adult donor to a small or size-matched recipient with a high risk of DGF and studied GFR, RPP using MRI, and markers of kidney injury within 10 h after transplantation. After induction of BD, kidneys were removed from ∼63-kg donors and kept in cold storage for ∼22 h until transplanted into small (∼15 kg, n = 8) or size-matched (n = 8) recipients. A reduction in GFR was observed in small recipients within 60 min after reperfusion. Interestingly, this was associated with a significant reduction in medullary RPP, while there was no significant change in the size-matched recipients. No difference was observed in urinary NGAL excretion between the groups. A significant higher level of HO-1 mRNA was observed in small recipients than in donors and size-matched recipients indicating cortical injury. Improvement in early graft perfusion may be a goal to improve short- and long-term GFR and avoid graft thrombosis in pediatric recipients.

Testing Danegaptide Effects on Kidney Function after Ischemia/Reperfusion Injury in a New Porcine Two Week Model

“…These observations are supported by other studies [ 6 , 10 , 33 ]. In contrast to previous observations in a porcine renal-transplantation model [ 34 , 35 ] no changes in renal blood flow was observed following I/R-I, neither in the cortex nor the medulla. Also, no difference in blood flow was observed between the left injured kidney and the right kidney.…”

New Pharmacological Treatment to Preserve/Improve Renal Function After Partial Nephrectomy

“…In their studies of kidney donation and effects of kidney ischemia in pigs they were able to demonstrate the feasibility of the methods and the reproducibility of the technique of measurement of GFR using 51 CR EDTA as radiotracer. Another important consideration is these investigations is to address the resistance to ischemic injury that the pigs have [87,88]. Therefore, we decided to adopt a similar experimental strategy and use 1h ischemia time by clamping of the renal artery and vein to investigate if the treatment with Entresto ® for a period of 15 days could play a protective role at the kidney level in the immediate postoperative phase.…”