Nighttime Kidney Transplant From Donor With Controlled Cardiac Death: Greater Functionality at the Cost of More Complications?

Guerrero, Estefanía Ruiz; García-Baquero, Rodrigo; Pérez, Cristina Salvatierra; Fernández-Ávila, Cristina Margarita; Mazuecos, Auxiliadora; Álvarez-Ossorio, J.L.

doi:10.1016/j.transproceed.2021.07.060

Cited by 4 publications

(4 citation statements)

References 16 publications

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“…[15][16][17][18][19] Interestingly, the reported studies did also not find significant differences in the outcome for surgery at day-or nighttime in the most outcome parameters. [15][16][17][18][19] However, surgical complications of transplantation may be affected by working at night. 17 In fact, fatigue of the surgical team during night is another topic discussed regarding the variation in the daytime of surgery.…”

Section: Discussionmentioning

confidence: 82%

“…Currently, no data on circadian rhythm and daytime variation for HTx are available; however, there are a few studies that examine the effect on kidney and liver transplantation 15–19 . Interestingly, the reported studies did also not find significant differences in the outcome for surgery at day‐ or nighttime in the most outcome parameters 15–19 . However, surgical complications of transplantation may be affected by working at night 17 …”

Section: Discussionmentioning

confidence: 99%

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Impact of circadian rhythm and daytime variation on outcome after heart transplantation

Immohr

Mehdiani

Oehler

et al. 2023

Clinical Transplantation

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Intro Recently, the impact of circadian rhythm and daytime variation on surgical outcomes has attracted interest. Although studies for coronary artery and aortic valve surgery report contrary results, effects on heart transplantation have not been studied. Methods Between 2010 and February 2022, 235 patients underwent HTx in our department. The recipients were reviewed and categorized according to the start of the HTx procedure – between 04:00 am and 11:59 am (morning, n = 79), 12:00 pm and 07:59 pm (afternoon, n = 68) or 08:00 pm and 03:59 am (night, n = 88). Results The incidence of high urgency status was slightly but not significantly increased (p = .08) in the morning (55.7%), compared to the afternoon (41.2%) or night (39.8%). The most important donor and recipient characteristics were comparable among the three groups. The incidence of severe primary graft dysfunction (PGD) requiring extracorporeal life support (morning: 36.7%, afternoon: 27.3%, night: 23.0%, p = .15) was also similarly distributed. In addition, there were no significant differences for kidney failure, infections, and acute graft rejection. However, the incidence of bleeding that required rethoracotomy showed an increased trend in the afternoon (morning: 29.1%, afternoon: 40.9%, night: 23.0%, p = .06). 30‐day survival (morning: 88.6%, afternoon: 90.8%, night: 92.0%, p = .82) and 1‐year survival (morning: 77.5%, afternoon: 76.0%, night: 84.4%, p = .41) were comparable between all groups. Conclusion Circadian rhythm and daytime variation did not affect the outcome after HTx. Postoperative adverse events as well as survival were comparable throughout day‐ and night‐time. As the timing of the HTx procedure is rarely possible and depends on the timing of organ recovery, these results are encouraging, as they allow for the continuation of the prevalent practice.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Impact of circadian rhythm and daytime variation on outcome after heart transplantation

Immohr

Mehdiani

Oehler

et al. 2023

Clinical Transplantation

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“…Thus, the cohort studies referring to the impact of time-of-day on graft outcomes and complications in patients undergoing renal transplant is still controversial with limited numbers in recent years. Although a few studies did not observe the difference of time-of-day on outcomes, it may be due to the disorder of preoperative biological rhythm in patients with ESRF (Ville, et al, 2021) (Treacy, et al, 2022) (Sugünes, et al, 2019) (Guerrero, et al, 2021). Meanwhile, the latest cohort study with 10291 patients observed that compared to nocturnal declamping, day-time declamping was associated with a better prognosis of kidney transplantation despite a longer duration of cold ischemia (Montaigne, et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, we can improve the establishment of RDN to explore the effects of afferent and efferent nerves (Qiu, et al, 2018) on renal IR injury associated with circadian rhythm respectively. Secondly, a few clinic observations referring to the impact of time-of-day on graft outcomes and complications in patients undergoing renal transplant haven't observe the difference of time-of-day on outcomes, which may be due to the disorder of preoperative circadian rhythm in patients with ESRF (Treacy, et al, 2022) (Sugünes, et al, 2019) (Guerrero, et al, 2021). However, the EDSF model has not been used in this study, which is a certain gap with clinical renal transplant.…”

Section: Limitation and Future Studymentioning

confidence: 93%

Denervation Aggravates Renal Ischemia Reperfusion Injury via BMAL1-mediated Nrf2/ARE pathway

Sun

WANG

Tang

et al. 2022

Preprint

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Background Denervation is an inevitable pathological situation of renal graft. This study was to explore the change of clock gene rhythm under renal denervation (RDN) and its effect on renal function and oxidative stress during renal ischemia-reperfusion (IR) injury. Method C57/BL6 mice were randomly divided into 4 groups at daytime 7AM (zeitgeber time [ZT] 0) or at nighttime 7PM (ZT12) in respectively: Sham (S) group, RDN group, IR group and RDN+ IR (DIR) group. Renal pathological and functional changes were assessed by H&E staining, and serum creatinine, urea nitrogen and neutrophil gelatinase-associated lipocalin levels. Renal oxidative stress was detected by SOD and MDA levels, and renal inflammation was measured by IL-6, IL-17AF and TNF-ɑ levels. BMAL1, CLOCK, Nrf2 and HO-1 mRNA and protein expressions were tested by qPCR and Western Blot. Result Compared with S groups, the rhythm of BMAL1 and CLOCK genes in the kidney was disordered in RDN groups, while renal pathological and functional indexes did not change significantly. Compared with IR groups, renal pathological and functional indexes were significantly higher in the DIR groups, as well as oxidative stress and inflammation in renal tissues. The protein expressions of BMAL1 and Nrf2 were upregulated by RDN at ZT12 timepoint. In DIR groups, renal injury was aggravated after the Brusatol treatment, but there was no significant improvement after the t-BHQ treatment, which might be consistent with the changes of Nrf2 and HO-1 protein expressions. Knockdown BMAL1 gene alone didn’t reverse the aggravation of renal IR injury at nighttime caused by RDN, but it could recover the protective effect of activating Nrf2/ARE pathway by t-BHQ. Conclusion RDN lead to the disruption of BMAL1-mediatedNrf2 rhythm accumulation in the kidney, which reduced the renal ability to resist oxidative stress and inflammation, due to the impaired effect of activating Nrf2/ARE pathway in renal IR injury at nighttime.

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Denervation aggravates renal ischemia reperfusion injury via BMAL1-mediated Nrf2/ARE pathway

Dong,

Li,

Tang

et al. 2023

Archives of Biochemistry and Biophysics

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Nighttime Kidney Transplant From Donor With Controlled Cardiac Death: Greater Functionality at the Cost of More Complications?

Cited by 4 publications

References 16 publications

Impact of circadian rhythm and daytime variation on outcome after heart transplantation

Impact of circadian rhythm and daytime variation on outcome after heart transplantation

Denervation Aggravates Renal Ischemia Reperfusion Injury via BMAL1-mediated Nrf2/ARE pathway

Denervation aggravates renal ischemia reperfusion injury via BMAL1-mediated Nrf2/ARE pathway

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