AI Article Synopsis

  • Delayed graft function (DGF) affects about 25% of kidneys donated after brain death, complicating transplant outcomes.
  • Remote ischaemic conditioning (rIC) involves inducing short periods of ischaemia in a distant tissue and has been shown to help protect against ischaemic injuries.
  • In a study using a pig kidney transplant model, rIC improved early renal plasma perfusion and glomerular filtration rate (GFR), suggesting it could enhance kidney graft function following transplantation.

Article Abstract

Delayed graft function (DGF) complicates approximately 25% of kidney allografts donated after brain death (DBD). Remote ischaemic conditioning (rIC) involves brief, repetitive, ischaemia in a distant tissue in connection with ischaemia/reperfusion in the target organ. rIC has been shown to induce systemic protection against ischaemic injuries. Using a porcine kidney transplantation model with donor (63 kg) recipient (15 kg) size mismatch, we investigated the effects of recipient rIC on early renal plasma perfusion and GFR. Brain death was induced in donor pigs (n = 8) and kidneys were removed and kept in cold storage until transplantation. Nephrectomized recipient pigs were randomized to rIC (n = 8) or non-rIC (n = 8) with one kidney from the same donor in each group. rIC consisted of 4 × 5 min clamping of the abdominal aorta. GFR was significantly higher in the rIC group compared with non-rIC (7.2 ml/min vs. 3.4 ml/min; ΔGFR = 3.7 ml/min, 95%-CI: 0.3-7.2 ml/min, P = 0.038). Renal plasma perfusion in both cortex and medulla measured by dynamic contrast-enhanced magnetic resonance imaging (MRI) was significantly higher over time in the rIC group compared with non-rIC. This experimental study demonstrated a positive effect of rIC on early graft perfusion and function in a large animal transplantation model.

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Source
http://dx.doi.org/10.1111/j.1432-2277.2012.01522.xDOI Listing

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