Simon Ville1, Marine Lorent2, Clarisse Kerleau2, Anders Asberg3, Christophe Legendre4, Emmanuel Morelon5, Fanny Buron5, Valérie Garrigue6, Moglie Le Quintrec6, Sophie Girerd7, Marc Ladrière7, Laetitia Albano8, Antoine Sicard8, Denis Glotz9, Carmen Lefaucheur9, Julien Branchereau1,10, David Jacobi11, Magali Giral. 1. Institut de Transplantation Urologie Néphrologie, CHU Nantes, Nantes, France. 2. CRTI UMR 1064, Institut National de la Santé et de la Recherche Médicale (INSERM), University of Nantes, ITUN, CHU Nantes, RTRS Centaure, Nantes, France. 3. Department of Transplantation Medicine, Oslo University Hospital, Department of Pharmacy, University of Oslo, Oslo, Norway. 4. Kidney Transplant Center, Necker University Hospital, Assistance Publique-Hôpitaux de Paris, RTRS Centaure, Paris Descartes and Sorbonne Paris Cité Universities, Paris, France. 5. Nephrology, Transplantation and Clinical Immunology Department, RTRS Centaure, Edouard Herriot University Hospital, Hospices Civils, Lyon, France. 6. Nephrology, Dialysis and Transplantation Department, Lapeyronie University Hospital, Montpellier, France. 7. Renal Transplantation Department, Brabois University Hospital, Nancy, France. 8. Department of Nephrology and Renal Transplantation, Hospital Pasteur, Nice, France. 9. Department of Nephrology and Renal Transplantation, CHU Paris-GH Saint-Louis, Lariboisière, France. 10. Urology Unit, University of Nantes, ITUN, CHU Nantes, Nantes, France. 11. Thorax Institut, INSERM, Centre National de la Recherche Scientifique (CNRS), University of Nantes, CHU Nantes, Nantes, France.
Abstract
BACKGROUND AND OBJECTIVES: The fact that metabolism and immune function are regulated by an endogenous molecular clock that generates circadian rhythms suggests that the magnitude of ischemia reperfusion, and subsequent inflammation on kidney transplantation, could be affected by the time of the day. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We evaluated 5026 individuals who received their first kidney transplant from deceased heart-beating donors. In a cause-specific multivariable analysis, we compared delayed graft function and graft survival according to the time of kidney clamping and declamping. Participants were divided into those clamped between midnight and noon (ante meridiem [am] clamping group; 65%) or clamped between noon and midnight (post meridiem [pm] clamping group; 35%), and, similarly, those who underwent am declamping (25%) or pm declamping (75%). RESULTS: Delayed graft function occurred among 550 participants (27%) with am clamping and 339 (34%) with pm clamping (adjusted odds ratio, 0.81; 95% confidence interval, 0.67 to 0.98; P=0.03). No significant association was observed between clamping time and overall death-censored graft survival (hazard ratio, 0.92; 95% confidence interval, 0.77 to 1.10; P=0.37). No significant association of declamping time with delayed graft function or graft survival was observed. CONCLUSIONS: Clamping between midnight and noon was associated with a lower incidence of delayed graft function, whereas declamping time was not associated with kidney graft outcomes.
BACKGROUND AND OBJECTIVES: The fact that metabolism and immune function are regulated by an endogenous molecular clock that generates circadian rhythms suggests that the magnitude of ischemia reperfusion, and subsequent inflammation on kidney transplantation, could be affected by the time of the day. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We evaluated 5026 individuals who received their first kidney transplant from deceased heart-beating donors. In a cause-specific multivariable analysis, we compared delayed graft function and graft survival according to the time of kidney clamping and declamping. Participants were divided into those clamped between midnight and noon (ante meridiem [am] clamping group; 65%) or clamped between noon and midnight (post meridiem [pm] clamping group; 35%), and, similarly, those who underwent am declamping (25%) or pm declamping (75%). RESULTS: Delayed graft function occurred among 550 participants (27%) with am clamping and 339 (34%) with pm clamping (adjusted odds ratio, 0.81; 95% confidence interval, 0.67 to 0.98; P=0.03). No significant association was observed between clamping time and overall death-censored graft survival (hazard ratio, 0.92; 95% confidence interval, 0.77 to 1.10; P=0.37). No significant association of declamping time with delayed graft function or graft survival was observed. CONCLUSIONS: Clamping between midnight and noon was associated with a lower incidence of delayed graft function, whereas declamping time was not associated with kidney graft outcomes.
Authors: Ludovic S Mure; Hiep D Le; Giorgia Benegiamo; Max W Chang; Luis Rios; Ngalla Jillani; Maina Ngotho; Thomas Kariuki; Ouria Dkhissi-Benyahya; Howard M Cooper; Satchidananda Panda Journal: Science Date: 2018-02-08 Impact factor: 47.728
Authors: David Druzd; Olga Matveeva; Louise Ince; Ute Harrison; Wenyan He; Christoph Schmal; Hanspeter Herzel; Anthony H Tsang; Naoto Kawakami; Alexei Leliavski; Olaf Uhl; Ling Yao; Leif Erik Sander; Chien-Sin Chen; Kerstin Kraus; Alba de Juan; Sophia Martina Hergenhan; Marc Ehlers; Berthold Koletzko; Rainer Haas; Werner Solbach; Henrik Oster; Christoph Scheiermann Journal: Immunity Date: 2017-01-10 Impact factor: 31.745