Prognostic significance of free radicals: mediated injury occurring in the kidney donor

Kosieradzki, Maciej; Kuczyńska, Julita; Piwowarska, Jadwiga; Wegrowicz-Rebandel, Irena; Kwiatkowski, A.; Lisik, Wojciech; Michalak, Grzegorz; Danielewicz, R.; Pączek, Leszek; Rowińskí, W

doi:10.1097/01.tp.0000065282.46425.87

Cited by 75 publications

(45 citation statements)

References 22 publications

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“…Moreover, recent studies report on a causal relationship between hemodynamic impairment and a systemic inflammatory response during BD (11,32). Recently, Kosieradzki et al showed that elevated MDA levels, indicative for oxidative/ischemic stress, in serum of human brain dead donors correlated with an inferior outcome after kidney transplantation (33). Our results on both the ROS formation in the kidney and systemic MDA, clearly indicate that ischemic stress primarily occurs in the later phases of BD.…”

Section: Discussionsupporting

confidence: 67%

Time-Dependent Changes in Donor Brain Death Related Processes

Schuurs¹,

Morariu

Ottens³

et al. 2006

American Journal of Transplantation

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Section: Discussionsupporting

confidence: 67%

Time-Dependent Changes in Donor Brain Death Related Processes

Schuurs¹,

Morariu

Ottens³

et al. 2006

American Journal of Transplantation

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“…Glutathione-S-transferase (GST), a more specific marker of renal tubular injury, and Heart-type fatty acid binding protein (HFABP), generally released under ischemic conditions, have also shown good correlations with DGF [29]. Other biomarkers of potential interest as implicated in the process of ischemia/reperfusion injury are N-acetyl-β-D-glucosaminidase (NAG) [29], malondialdehyde (MDA) [30], redox-active iron [31], and IL-18. IL-18 in particular, released by mononuclear cells in response to oxidative stress, has been associated with PNF in controlled and uncontrolled DCD kidney transplants [28].…”

Section: Organ Assessmentmentioning

confidence: 99%

Hypothermic Machine Perfusion in Kidney Transplantation: Back to the Future?

Ferraresso¹,

Favi²

2015

J Transplant Technol Res

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Static cold storage is currently the most used method of organ preservation worldwide. However, cutting edge technology and dramatic changes in the donor pattern have lately renewed the interest toward hypothermic machine perfusion. Marginal and cardiac death donors show higher rates of primary non function and delayed graft function compared to standard criteria donors. In this setting, machine perfusion may offer several theoretical advantages such as improved organ preservation, continuous graft evaluation, and ex-vivo conditioning of the graft before implantation. These topics have been recently reassessed by several studies. In particular, perfusion characteristics (renal resistance) and perfusate biomarker concentrations (lactate dehydrogenase, aspartate aminotransferase, heart-type fatty acid binding protein, and IL-18) during machine preservation, proved to be reliable tools to rule out graft viability and predict outcomes after transplantation. Treatment strategies acting on tissue repair, cell metabolism, and allorecognition pathway are also under investigation with promising results. Machine perfusion has finally shown its real potential however, stronger evidences and updated cost-effectiveness analysis are needed to fully support its role for the next future.

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“…83,84 However, it is uncertain whether the beneficial effect of corticosteroids in cadaveric donors is a result of hormonal replacement or a modulatory effect of the inflammatory process described after the NDD. 21,[85][86][87][88] A recent consensus has recommended that donors with a left ventricular ejection fraction of less than 45% after standard management be treated with a combination of methylprednisolone, T3, and vasopressin. 4,5 This recommendation is supported by an observational study involving 10,292 consecutive brain dead organ donors within the United Network for Organ Sharing database which showed a significant improvement in organ procurement and an increased odds of a donor becoming an organ donor if treated with triple hormonal therapy.…”

Section: Temporal Considerationsmentioning

confidence: 99%

“…19 As a consequence of both the loss of sympathetic nervous system control and concomitant diabetes insipidus (DI), only a minority of cadaveric donors are able to maintain hemodynamic stability. [20][21][22][23] Cardiovascular monitoring and support Traditionally, dopamine has been used as the inotrope of choice in the cadaveric donor, however recent studies have not supported the beneficial effect of dopamine on renal or hepatosplanchnic circulation, and dopamine may suppress the function of anterior pituitary hormones. 24,25 Consequently, there has been a move towards the use of medications such as vasopressin for the vasodilatory shock seen in cadaveric donors.…”

Section: Temporal Considerationsmentioning

confidence: 99%

Traitement médical pour optimaliser le potentiel de don d’organe : une revue documentaire

Kutsogiannis

Pagliarello

Doig

et al. 2006

Can J Anesth/J Can Anesth

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Purpose: Over the past two decades, the demand for donor organs continues to outpace the number of organs available for transplantation. Parallel with this has been a change in the demographics of organ donors with an increase in older donors and donors with marginal organs as a proportion of the total organ donor pool. Consequently, efforts have been made to improve the medical care delivered to potential organ donors to improve the conversion rate and graft survival of available organs. The purpose of this literature review is to provide updated recommendations for the contemporary management of organ donors after the neurological determination of death in order to maximize the probability of recipient graft survival. Sources:A comprehensive review of the literature obtained through searches of MEDLINE/PubMed, and personal reference files.Principal findings: Contemporary management of the organ donor after neurological determination of death includes therapies to prevent the detrimental effects of the autonomic storm, the use of invasive hemodynamic monitoring and aggressive respiratory therapy including therapeutic bronchoscopy in marginal heart and lung donors, and the use of hormonal therapy including vasopressin, corticosteroids, triiodothyronine or thyroxine, and insulin for the pituitary failure and inflammation seen in brain dead organ donors. The importance of normalizing donor physiology to optimize all available organs is stressed. Conclusion:Aggressive hemodynamic and respiratory management of solid organ donors, coupled with the use of hormonal therapy improves the rate of conversion and graft survival in solid organ recipients. Objectif

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Prognostic significance of free radicals: mediated injury occurring in the kidney donor

Abstract: Free-radical mediated injury occurring in the donor and during preservation is strictly correlated with immediate and long-term kidney function. It may also cause grafts to be prone to acute rejection.

Cited by 75 publications

References 22 publications

Time-Dependent Changes in Donor Brain Death Related Processes

Time-Dependent Changes in Donor Brain Death Related Processes

Hypothermic Machine Perfusion in Kidney Transplantation: Back to the Future?

Traitement médical pour optimaliser le potentiel de don d’organe : une revue documentaire

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