Biological Modulation of Renal Ischemia-reperfusion Injury

Overview

Journal Curr Opin Organ Transplant

Specialty General Surgery

Date 2009 Dec 17

PMID 20009928

Citations 22

Authors

Maarten G J Snoeijs

L W Ernest van Heurn

Wim A Buurman

Affiliations

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Abstract

Purpose Of Review: Biological modulation of renal ischemia-reperfusion injury holds the potential to reduce the incidence of early graft dysfunction and to safely expand the donor pool with kidneys that have suffered prolonged ischemic injury before organ recovery.

Recent Findings: In the current review, we will discuss clinical studies that compare kidney transplant recipients with and without early graft dysfunction in order to elucidate the pathophysiology of ischemic acute allograft injury. We will specifically review the mechanisms leading to depression of the glomerular filtration rate and activation of the innate immune system in response to tissue injury.

Summary: We conclude that the pathophysiology of delayed graft function after kidney transplantation is complex and shares broad similarity with rodent models of ischemic acute kidney injury. Given the lack of specific therapies to prevent delayed graft function in transplant recipients, comprehensive efforts should be initiated to translate the promising findings obtained in small animal models into clinical interventions that attenuate ischemic acute kidney injury after transplantation.

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