BACKGROUND: Cadaveric kidneys experiencing longer cold ischemia time (CIT) are associated with higher levels of delayed graft function, acute rejection, and early graft loss. One mechanism to explain these results is that ischemia/reperfusion (I/R) injury makes the allograft more immunogenic by upregulating molecules involved in the immune response (e.g., HLA Class I/II). METHODS: We evaluated the influence of CIT on the production of HLA Class I antibody level, measured by an antihuman globulin panel reactive antibody (AHG PRA) level, in 90 unsensitized recipients of primary cadaveric renal transplants (from a total of 1442 between 1985 and 1997) who rejected their kidneys. RESULTS: By multivariate analysis, a CIT of 15 hr or more (vs. < 15 hr) independently increased the risk of the AHG Class I PRA level being > or = 20% after unsensitized patients rejected their first kidneys (relative risk=3.57; 95% confidence interval=1.26 to 10.14; P=0.01), despite the same degree of Class I/II mismatch between the two CIT groups. The overall mean peak PRA level after primary kidney rejection was significantly lower for the CIT < 15 hr group (25.9%+/-33.9; n=24) compared with the CIT > or = 15 hr group (46.3%+/-36.5; n=66) (P<0.001). CONCLUSION: Longer CIT induces a humorally more immunogenic kidney.
BACKGROUND: Cadaveric kidneys experiencing longer cold ischemia time (CIT) are associated with higher levels of delayed graft function, acute rejection, and early graft loss. One mechanism to explain these results is that ischemia/reperfusion (I/R) injury makes the allograft more immunogenic by upregulating molecules involved in the immune response (e.g., HLA Class I/II). METHODS: We evaluated the influence of CIT on the production of HLA Class I antibody level, measured by an antihuman globulin panel reactive antibody (AHG PRA) level, in 90 unsensitized recipients of primary cadaveric renal transplants (from a total of 1442 between 1985 and 1997) who rejected their kidneys. RESULTS: By multivariate analysis, a CIT of 15 hr or more (vs. < 15 hr) independently increased the risk of the AHG Class I PRA level being > or = 20% after unsensitized patients rejected their first kidneys (relative risk=3.57; 95% confidence interval=1.26 to 10.14; P=0.01), despite the same degree of Class I/II mismatch between the two CIT groups. The overall mean peak PRA level after primary kidney rejection was significantly lower for the CIT < 15 hr group (25.9%+/-33.9; n=24) compared with the CIT > or = 15 hr group (46.3%+/-36.5; n=66) (P<0.001). CONCLUSION: Longer CIT induces a humorally more immunogenic kidney.
Authors: Eric K Chow; Sandra DiBrito; Xun Luo; Corey E Wickliffe; Allan B Massie; Jayme E Locke; Sommer E Gentry; Jacqueline Garonzik-Wang; Dorry L Segev Journal: Transplantation Date: 2018-03 Impact factor: 4.939
Authors: Oliver Drognitz; Johannes Donauer; Judith Kamgang; Peter Baier; Hannes Neeff; Christian Lohrmann; Martin Pohl; Ulrich Theodor Hopt; Günter Kirste; Przemyslaw Pisarski Journal: Langenbecks Arch Surg Date: 2006-08-19 Impact factor: 3.445
Authors: Anja Gallinat; Andreas Paul; Thomas Minor; Jürgen W Treckmann; Ernesto P Molmenti; Oliver Witzke; Georgios C Sotiropoulos Journal: Int Urol Nephrol Date: 2012-07-01 Impact factor: 2.370
Authors: Merve Postalcioglu; Arnaud D Kaze; Benjamin C Byun; Andrew Siedlecki; Stefan G Tullius; Edgar L Milford; Julie M Paik; Reza Abdi Journal: Transplantation Date: 2018-07 Impact factor: 4.939