Synergistic effects of prolonged warm ischemia and donor age on the immune response following donation after cardiac death kidney transplantation

Denecke, Christian; Yuan, Xiaodong; Ge, Xiaowen; Kim, Irene; Bedi, Damanpreet S.; Boenisch, Olaf; Weiland, Anne; Jurisch, Anke; Kotsch, Katja; Pratschke, Johann; Reutzel‐Selke, Anja; Tullius, Stefan G.

doi:10.1016/j.surg.2012.07.035

Cited by 20 publications

(18 citation statements)

References 30 publications

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“…Expanding the use of DCD organs may improve access to transplantation, but some evidence suggests that DCD organs are associated with higher rates of complications than those procured after brain death, including biliary complications in liver transplantation and delayed graft function (DGF) in kidney transplantation (1,(3)(4)(5). Such outcomes are attributed to the exposure of DCD kidneys to hypoperfusion, hypoxia and inflammation during warm ischemia and reperfusion (6,7). Hemodynamic profiles during DWI vary widely among DCD donors, raising the possibility that measurable physiological perturbations may be useful predictors of recipient outcome (8).…”

Section: Introductionmentioning

confidence: 99%

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Donor Hemodynamics as a Predictor of Outcomes After Kidney Transplantation From Donors After Cardiac Death

Allen

Billig

Reese

et al. 2016

American Journal of Transplantation

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Section: Introductionmentioning

confidence: 99%

“…6 The following graft variables were assessed but were not associated with DGF (p > 0.20): donor warm ischemia time. 7 n is less than total due to missing data (513 for DGF, 459 for non-DGF).…”

Section: Introductionmentioning

confidence: 99%

Donor Hemodynamics as a Predictor of Outcomes After Kidney Transplantation From Donors After Cardiac Death

Allen

Billig

Reese

et al. 2016

American Journal of Transplantation

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“…Indeed, the wide range of rejection tempos in transplantation with outbred mice, spanning HAR to chronic rejection, contrasting with the unimodal acute rejection of cardiac allografts observed when using inbred strains, underscore this concern (Reichenbach et al 2013). Obesity, age, and the infectious history, as well as organ preservation times (Wehner et al 2010;Oberhuber et al 2012;Denecke et al 2013), which are highly variable in human transplantation, can also have profound effects on immune responses and graft outcomes. Understanding these caveats and modifying the mouse transplantation models to capture these variables may introduce complexities into the investigation but may allow for a more accurate translation of findings from mice to man.…”

Section: Discussionmentioning

confidence: 99%

Lessons and Limits of Mouse Models

Chong

Alegre

Miller

et al. 2013

Cold Spring Harbor Perspectives in Medicine

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Seminal studies in rabbits and rodent transplantation models by Peter Medawar revealed that cellular processes, rather than humoral antibodies, are central to the acute rejection of transplanted organs, and much of basic transplantation research continues to be focused on the biology and control of these cells, which were subsequently shown to be T cells. However, the success of current immunosuppression at controlling T-cell-mediated rejection has resulted in an increasing awareness of antibody-mediated rejection in the clinic. This, in turn, has fueled an emerging interest in the biology of allospecific antibodies, the B cells that produce these antibodies, and the development of mouse models that allow their investigation. Here we summarize some of the more widely used mouse models that have been developed to study the immunobiology of alloreactivity, transplantation rejection and tolerance, and used to identify therapeutic strategies that modulate these events. R odent models in transplantation have been essential to developing a mechanistic understanding of the process of allograft rejection, as well as to the identification of novel therapeutic approaches that prevent rejection. Models of transplantation tolerance in mice and other rodents have paved the way to translational studies of tolerance induction in nonhuman primates and humans, whereas the failures in translating the successes in tolerance induction observed in mice into the clinic have led to a closer examination of the limitations of the mouse models and the identification of physiological barriers to tolerance induction. ORGAN-SPECIFIC MODELS OF ACUTE REJECTIONClinicians have long appreciated the importance of the organ type in shaping the alloreactive immune response, with lungs and small intestines having a higher propensity to being rejected compared with hearts, kidneys, or livers. Early models of organ transplantation were limited by microsurgical techniques, and the skin transplant model was extensively used. With technical advances, the heterotopic heart transplantation model is now the model of choice, although other organ transplantation models, such as kidney or liver, offer unique advantages (see Fig. 1).

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“…[1][2][3][4] Because of advantages of rat models of RT over other animal models, such as improved long-term survival, lower cost, simplicity of animal maintenance, less critical requirements for aseptic surgery, and wellestablished surgical techniques of vascular and ureteric anastomoses for RT, the model is commonly employed in transplant-related research. 5 A rodent model of RT was first described in rat (Rattus norvegicus) in 1965 by Bernard Fisher and Sun Lee at the American College of Surgeons Meeting in Chicago in 1961, with subsequent publication in 1965. 6 Microvascular techniques have undergone several modifications to establish blood flow through arterial and venous anastomoses between donor blood vessels and recipient systemic circulation and urinary tract drainage via anastomosis to the recipient urinary tract to achieve successful RT with minimum morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Complications and Their Prevention in Experimental Renal Transplantation in Rats

Shrestha

Haylor²

2019

Exp Clin Transplant

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Objectives: Experimental rat models of renal transplant have played a pivotal role in renal transplant research. Both intraoperative and postoperative complications during donor nephrectomy and implantation in the recipient can be associated with significant morbidity and mortality. The aim of this paper is to discuss the incidence, pathophysiology, and prevention of complications that occurred in the process of establishment of a rat model of chronic allograft injury at our institution. Materials and Methods: The complications observed while performing 67 consecutive donor nephrectomies and 61 renal transplants were recorded prospectively, and appropriate measures were taken to prevent these complications in the subsequent transplant procedures. Results: Donor-related complications included failure of the kidney to clear of blood by the kidney perfusion solution and intraoperative deaths. The recipientrelated complications included intraoperative hemorrhage, inadequately perfused kidneys with dusky appearance, congested and paralyzed hind limbs, urine leak, necrosis of the kidneys, renal and bladder calculi formation, and death during and after kidney transplant. Conclusions: Complications during donor nephrectomy and renal transplant can lead to significant loss of kidneys and animals. Proper recognition can allow appropriate measures to be taken to prevent these complications, thus achieving high-quality transplants and prolonged graft and animal survival.

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Synergistic effects of prolonged warm ischemia and donor age on the immune response following donation after cardiac death kidney transplantation

Cited by 20 publications

References 30 publications

Donor Hemodynamics as a Predictor of Outcomes After Kidney Transplantation From Donors After Cardiac Death

Donor Hemodynamics as a Predictor of Outcomes After Kidney Transplantation From Donors After Cardiac Death

Lessons and Limits of Mouse Models

Complications and Their Prevention in Experimental Renal Transplantation in Rats

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