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Voss NCS, Nielsen TK, Madsen MG, Chynau Y, Cao T, Møldrup U, Keller AK. Pulmonary embolisms and infections after renal trauma. Dan Med J 2023; 70:A01230014. [PMID: 37622643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
INTRODUCTION The objective of this study was to describe and evaluate the management of patients with renal trauma and their complications at the Department of Urology at Aarhus University Hospital (AUH), Denmark. METHODS All patients diagnosed with renal injury due to trauma and with contact to the Department of Urology at the AUH, Denmark, between March 2016 and March 2021 were included. Patients were identified by the International Classification of Diseases, Tenth version, code and data obtained from electronic patient records. RESULTS A total of 58 patients were identified. The median age was 33 years (7-95 years) and the median length of hospitalisation was five days (range: 0-52 days). All patients were evaluated with a multiphase computed tomography upon admission. Injuries to the kidney were graded using the American Association for the Surgery of Trauma kidney injury scale. Twelve percent had grade I injury, 26% had grade II injury, 26% had grade III injury, 36% had grade IV injury and 3% had grade V injury. In the acute phase, all patients were managed non-operatively. Early complications were found in 24% of patients. Pulmonary embolism was diagnosed in 7%. Furthermore, 7% had an infection as a late complication and all of these patients had also had an early infection. A total of 60% were followed up with a renal-scintigraphy three months after their renal trauma. This examination had no consequence for any of the patients. CONCLUSIONS No patients died due to the renal trauma. However, many experienced complications in terms of infections and pulmonary embolisms. These data support earlier findings and suggest that a renal scintigraphy after renal traumas may be obsolete. FUNDING None. TRIAL REGISTRATION Not relevant.
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Affiliation(s)
| | | | | | - Yahor Chynau
- Department of Urology, Aarhus University Hospital, Denmark
| | - Trang Cao
- Department of Urology, Aarhus University Hospital, Denmark
| | - Ulla Møldrup
- Department of Urology, Aarhus University Hospital, Denmark
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Lohmann S, Pool MBF, Rozenberg KM, Keller AK, Moers C, Møldrup U, Møller BK, Lignell SJM, Krag S, Sierra-Parraga JM, Lo Faro ML, Hunter J, Hoogduijn MJ, Baan CC, Leuvenink HGD, Ploeg RJ, Eijken M, Jespersen B. Mesenchymal stromal cell treatment of donor kidneys during ex vivo normothermic machine perfusion: A porcine renal autotransplantation study. Am J Transplant 2021; 21:2348-2359. [PMID: 33382194 DOI: 10.1111/ajt.16473] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 01/25/2023]
Abstract
Normothermic machine perfusion (NMP) of injured kidneys offers the opportunity for interventions to metabolically active organs prior to transplantation. Mesenchymal stromal cells (MSCs) can exert regenerative and anti-inflammatory effects in ischemia-reperfusion injury. The aims of this study were to evaluate the safety and feasibility of MSC treatment of kidneys during NMP using a porcine autotransplantation model, and examine potential MSC treatment-associated kidney improvements up to 14 days posttransplant. After 75 min of kidney warm ischemia, four experimental groups of n = 7 underwent 14 h of oxygenated hypothermic machine perfusion. In three groups this was followed by 240 min of NMP with infusion of vehicle, 10 million porcine, or 10 million human adipose-derived MSCs. All kidneys were autotransplanted after contralateral nephrectomy. MSC treatment did not affect perfusion hemodynamics during NMP or cause adverse effects at reperfusion, with 100% animal survival. MSCs did not affect plasma creatinine, glomerular filtration rate, neutrophil gelatinase-associated lipocalin concentrations or kidney damage assessed by histology during the 14 days, and MSCs retention was demonstrated in renal cortex. Infusing MSCs during ex vivo NMP of porcine kidneys was safe and feasible. Within the short posttransplant follow-up period, no beneficial effects of ex vivo MSC therapy could be demonstrated.
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Affiliation(s)
- Stine Lohmann
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Merel B F Pool
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | | | - Anna K Keller
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Urology, Aarhus University Hospital, Aarhus, Denmark
| | - Cyril Moers
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Ulla Møldrup
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark
| | - Bjarne K Møller
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Stina J M Lignell
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Søren Krag
- Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
| | - Jesus M Sierra-Parraga
- Department of Internal Medicine, Nephrology and Transplantation, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Maria L Lo Faro
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - James Hunter
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Martin J Hoogduijn
- Department of Internal Medicine, Nephrology and Transplantation, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Carla C Baan
- Department of Internal Medicine, Nephrology and Transplantation, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Henri G D Leuvenink
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Rutger J Ploeg
- Department of Surgery - Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.,Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Marco Eijken
- Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Bente Jespersen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark
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Lohmann S, Eijken M, Møldrup U, Møller BK, Hunter J, Moers C, Leuvenink H, Ploeg RJ, Clahsen-van Groningen MC, Hoogduijn M, Baan CC, Keller AK, Jespersen B. Ex Vivo Administration of Mesenchymal Stromal Cells in Kidney Grafts Against Ischemia-reperfusion Injury-Effective Delivery Without Kidney Function Improvement Posttransplant. Transplantation 2021; 105:517-528. [PMID: 32956281 DOI: 10.1097/tp.0000000000003429] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Mesenchymal stromal cell (MSC) therapy may improve renal function after ischemia-reperfusion injury in transplantation. Ex vivo renal intraarterial administration is a targeted delivery method, avoiding the lung vasculature, a known barrier for cellular therapies. In a randomized and blinded study, we tested the feasibility and effectiveness of MSC therapy in a donation after circulatory death autotransplantation model to improve posttransplant kidney function, using an ex vivo MSC delivery method similar to the clinical standard procedure of pretransplant cold graft flush. METHODS Kidneys exposed to 75 minutes of warm ischemia and 16 hours of static cold storage were intraarterially infused ex vivo with 10 million male porcine MSCs (Tx-MSC, n = 8) or vehicle (Tx-control, n = 8). Afterwards, the kidneys were autotransplanted after contralateral nephrectomy. Biopsies an hour after reperfusion confirmed the presence of MSCs in the renal cortex. Animals were observed for 14 days. RESULTS Postoperatively, peak plasma creatinine was 1230 and 1274 µmol/L (Tx-controls versus Tx-MSC, P = 0.69). During follow-up, no significant differences over time were detected between groups regarding plasma creatinine, plasma neutrophil gelatinase-associated lipocalin, or urine neutrophil gelatinase-associated lipocalin/creatinine ratio. At day 14, measured glomerular filtration rates were 40 and 44 mL/min, P = 0.66. Renal collagen content and fibrosis-related mRNA expression were increased in both groups but without significant differences between the groups. CONCLUSIONS We demonstrated intraarterial MSC infusion to transplant kidneys as a safe and effective method to deliver MSCs to the graft. However, we could not detect any positive effects of this cell treatment within 14 days of observation.
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Affiliation(s)
- Stine Lohmann
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Marco Eijken
- Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Ulla Møldrup
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark
| | - Bjarne K Møller
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - James Hunter
- Nuffield Department of Surgical Sciences, Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
| | - Cyril Moers
- Department of Surgery-Organ Donation and Transplantation, University of Medical Center Groningen, Groningen, the Netherlands
| | - Henri Leuvenink
- Department of Surgery-Organ Donation and Transplantation, University of Medical Center Groningen, Groningen, the Netherlands
| | - Rutger J Ploeg
- Nuffield Department of Surgical Sciences, Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
| | | | - Martin Hoogduijn
- Department of Internal Medicine, Nephrology and Transplantation, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Carla C Baan
- Department of Internal Medicine, Nephrology and Transplantation, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Anna Krarup Keller
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark
| | - Bente Jespersen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark
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Amdisen C, Jespersen B, Møldrup U, Keller AK. The unsuitability of implantable Doppler probes for the early detection of renal vascular complications - a porcine model for prevention of renal transplant loss. PLoS One 2017; 12:e0178301. [PMID: 28542429 PMCID: PMC5444816 DOI: 10.1371/journal.pone.0178301] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 05/10/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Vascular occlusion is a rare, but serious complication after kidney transplantation often resulting in graft loss. We therefore aimed to develop an experimental porcine model for stepwise reduction of the renal venous blood flow and to compare an implantable Doppler probe and microdialysis for fast detection of vascular occlusion. METHODS In 20 pigs, implantable Doppler probes were placed on the renal artery and vein and a microdialysis catheter was placed in the renal cortex. An arterial flowprobe served as gold standard. Following two-hour baseline measurements, the pigs were randomised to stepwise venous occlusion, complete venous occlusion, complete arterial occlusion or controls. RESULTS All parameters were stable through baseline measurements. Glutamate and lactate measured by microdialysis increased significantly (p = 0.02 and p = 0.03 respectively) 30 minutes after a 2/3 (66%) reduction in renal blood flow. The implantable Doppler probe was not able to detect flow changes until there was total venous occlusion. Microdialysis detected changes in local metabolism after both arterial and venous occlusion; the implantable Doppler probe could only detect vascular occlusions on the vessel it was placed. CONCLUSIONS We developed a new model for stepwise renal venous blood flow occlusion. Furthermore, the first comparison of the implantable Doppler probe and microdialysis for detection of renal vascular occlusions was made. The implantable Doppler probe could only detect flow changes after a complete occlusion, whereas microdialysis detected changes earlier, and could detect both arterial and venous occlusion. Based on these results, the implantable Doppler probe for early detection of vascular occlusions cannot be recommended.
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Affiliation(s)
- Chris Amdisen
- Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark
- * E-mail:
| | - Bente Jespersen
- Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Ulla Møldrup
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark
| | - Anna K. Keller
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark
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Krogstrup NV, Oltean M, Nieuwenhuijs-Moeke GJ, Dor FJMF, Møldrup U, Krag SP, Bibby BM, Birn H, Jespersen B. Remote Ischemic Conditioning on Recipients of Deceased Renal Transplants Does Not Improve Early Graft Function: A Multicenter Randomized, Controlled Clinical Trial. Am J Transplant 2017; 17:1042-1049. [PMID: 27696662 DOI: 10.1111/ajt.14075] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 09/20/2016] [Accepted: 09/22/2016] [Indexed: 01/25/2023]
Abstract
Delayed graft function is a frequent complication following deceased donor renal transplantation, and is closely related to ischemia-reperfusion injury. Experimental and clinical studies have shown protection by remote ischemic conditioning (RIC). We hypothesized that recipient RIC before kidney graft reperfusion reduces the time to graft recovery. This multicenter, blinded, randomized, controlled clinical trial included 225 adult recipients of renal transplants from deceased donors at four transplantation centers in Denmark, Sweden, and the Netherlands. Participants were randomized 1:1 to RIC or sham-RIC. RIC consisted of 4 × 5-min thigh occlusion by an inflatable tourniquet each followed by 5-min deflation, performed during surgery prior to graft reperfusion. The tourniquet remained deflated for sham-RIC. The primary endpoint was the estimated time to a 50% decrease in baseline plasma creatinine (tCr50) calculated from plasma creatinine measurements 30 days posttransplant or 30 days after the last, posttransplant dialysis. No significant differences were observed between RIC and sham-RIC-treated patients in the primary outcome median tCr50 (122 h [95% confidence interval [CI] 98-151] vs. 112 h [95% CI 91-139], p = 0.58), or the number of patients receiving dialysis in the first posttransplant week (33% vs. 35%, p = 0.71). Recipient RIC does not reduce the time to graft recovery in kidney transplantation from deceased donors. ClinicalTrials.gov: NCT01395719.
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Affiliation(s)
- N V Krogstrup
- Department of Renal Medicine, Aarhus University, Aarhus, Denmark.,Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - M Oltean
- The Transplant Institute, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - G J Nieuwenhuijs-Moeke
- Department of Anaesthesiology, University Medical Center Groningen, Groningen, the Netherlands
| | - F J M F Dor
- Division of HPB & Transplant Surgery, Department of Surgery, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - U Møldrup
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark
| | - S P Krag
- Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
| | - B M Bibby
- Department of Biostatistics, Aarhus University, Aarhus, Denmark
| | - H Birn
- Department of Renal Medicine, Aarhus University, Aarhus, Denmark.,Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - B Jespersen
- Department of Renal Medicine, Aarhus University, Aarhus, Denmark.,Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Amdisen C, Keller AK, Hansen RS, Nørregaard R, Krag SP, Møldrup U, Pedersen M, Jespersen B, Birn H. Testing Danegaptide Effects on Kidney Function after Ischemia/Reperfusion Injury in a New Porcine Two Week Model. PLoS One 2016; 11:e0164109. [PMID: 27760220 PMCID: PMC5070773 DOI: 10.1371/journal.pone.0164109] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 09/20/2016] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Ischemia/reperfusion injury (I/R-I) is a leading cause of acute kidney injury (AKI) and is associated with increased mortality. Danegaptide is a selective modifier of the gap junction protein connexion 43. It has cytoprotective as well as anti-arrhythmic properties and has been shown to reduce the size of myocardial infarct in pigs. The aim of this study was to investigate the ischemia-protective effect of Danegaptide in a porcine renal I/R-I model with two weeks follow up. METHODS Unilateral renal I/R-I was induced in pigs by clamping the left renal artery over a two hour period. The model allowed examination of renal blood flow by magnetic resonance imaging (MRI) and the measurement of single kidney GFR two weeks after injury. Eleven animals were randomized to Danegaptide-infusion while nine animals received placebo. Kidney histology and urinary neutrophil gelatinase-associated lipocalin (NGAL) excretion were included as markers of AKI. RESULTS Unilateral kidney I/R-I resulted in an immediate ~50% GFR reduction, associated with a four-fold increase in urinary NGAL-excretion. Fourteen days after I/R-I, the total GFR was ~75% of baseline with a significantly lower GFR in the injured left kidney compared to the right kidney. No differences in GFR were observed between the treated and non-treated animals immediately after I/R-I or at Day 14. Furthermore, no differences were observed in the urinary excretion of NGAL, renal blood flow or other markers of renal function. CONCLUSIONS As expected this porcine renal I/R-I model was associated with reduced GFR two weeks after injury. Danegaptide did not improve renal function after I/R-I.
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Affiliation(s)
- Chris Amdisen
- Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Renal Medicine. Aarhus University Hospital, Aarhus, Denmark
- * E-mail:
| | - Anna K. Keller
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Rikke Nørregaard
- Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | - Ulla Møldrup
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Bente Jespersen
- Department of Renal Medicine. Aarhus University Hospital, Aarhus, Denmark
| | - Henrik Birn
- Department of Renal Medicine. Aarhus University Hospital, Aarhus, Denmark
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
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Krogstrup NV, Oltean M, Nieuwenhuijs-Moeke GJ, Dor FJMF, Møldrup U, Kragh SP, Bibby BM, Birn H, Jespersen B. SO013REMOTE ISCHAEMIC CONDITIONING ON RECIPIENTS OF DECEASED RENAL TRANSPLANTS DOES NOT IMPROVE EARLY GRAFT FUNCTION. A MULTICENTRE, RANDOMISED, CONTROLLED CLINICAL TRIAL. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw119.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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van Rijt W, Secher N, Keller A, Møldrup U, Chynau Y, Ploeg R, van Goor H, Nørregaard R, Birn H, Frøkiaer J, Nielsen S, Leuvenink H, Jespersen B. α-melanocyte stimulating hormone treatment does not improve early graft function in porcine brain dead kidney transplantation. Transpl Immunol 2014. [DOI: 10.1016/j.trim.2014.11.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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van Rijt WG, Secher N, Keller AK, Møldrup U, Chynau Y, Ploeg RJ, van Goor H, Nørregaard R, Birn H, Frøkiaer J, Nielsen S, Leuvenink HGD, Jespersen B. α-Melanocyte stimulating hormone treatment in pigs does not improve early graft function in kidney transplants from brain dead donors. PLoS One 2014; 9:e94609. [PMID: 24728087 PMCID: PMC3984270 DOI: 10.1371/journal.pone.0094609] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 03/17/2014] [Indexed: 01/24/2023] Open
Abstract
Delayed graft function and primary non-function are serious complications following transplantation of kidneys derived from deceased brain dead (DBD) donors. α-melanocyte stimulating hormone (α-MSH) is a pleiotropic neuropeptide and its renoprotective effects have been demonstrated in models of acute kidney injury. We hypothesized that α-MSH treatment of the recipient improves early graft function and reduces inflammation following DBD kidney transplantation. Eight Danish landrace pigs served as DBD donors. After four hours of brain death both kidneys were removed and stored for 18 hours at 4°C in Custodiol preservation solution. Sixteen recipients were randomized in a paired design into two treatment groups, transplanted simultaneously. α-MSH or a vehicle was administered at start of surgery, during reperfusion and two hours post-reperfusion. The recipients were observed for ten hours following reperfusion. Blood, urine and kidney tissue samples were collected during and at the end of follow-up. α-MSH treatment reduced urine flow and impaired recovery of glomerular filtration rate (GFR) compared to controls. After each dose of α-MSH, a trend towards reduced mean arterial blood pressure and increased heart rate was observed. α-MSH did not affect expression of inflammatory markers. Surprisingly, α-MSH impaired recovery of renal function in the first ten hours following DBD kidney transplantation possibly due to hemodynamic changes. Thus, in a porcine experimental model α-MSH did not reduce renal inflammation and did not improve short-term graft function following DBD kidney transplantation.
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Affiliation(s)
- Willem G. van Rijt
- Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands
- Department of Pathology and Medical Biology, University Medical Center Groningen, Groningen, The Netherlands
- * E-mail:
| | - Niels Secher
- Department of Anesthesiology, Aarhus University Hospital, Aarhus, Denmark
| | - Anna K. Keller
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark
| | - Ulla Møldrup
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark
| | - Yahor Chynau
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark
| | - Rutger J. Ploeg
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
| | - Harry van Goor
- Department of Pathology and Medical Biology, University Medical Center Groningen, Groningen, The Netherlands
| | - Rikke Nørregaard
- Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Henrik Birn
- Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark
- The Water and Salt Research Center, Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Jørgen Frøkiaer
- The Water and Salt Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Søren Nielsen
- The Water and Salt Research Center, Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Henri G. D. Leuvenink
- Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands
| | - Bente Jespersen
- Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark
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Keller A, Kierulf-Lassen C, Møldrup U, Bibby B, Jespersen B. Messengers of Renal Graft Quality During Warm and Cold Ischemia: A Porcine Microdialysis Study. Transplant Proc 2013; 45:1172-7. [DOI: 10.1016/j.transproceed.2012.10.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Ravlo K, Chhoden T, Søndergaard P, Secher N, Keller AK, Pedersen M, Bibby BM, Jørgensen TM, Møldrup U, Ostraat EØ, Birn H, Nørregaard R, Marcussen N, Leuvenink HG, Jespersen B. Early outcome in renal transplantation from large donors to small and size-matched recipients - a porcine experimental model. Pediatr Transplant 2012; 16:599-606. [PMID: 22584014 DOI: 10.1111/j.1399-3046.2012.01707.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Kidney transplantation from a large donor to a small recipient, as in pediatric transplantation, is associated with an increased risk of thrombosis and DGF. We established a porcine model for renal transplantation from an adult donor to a small or size-matched recipient with a high risk of DGF and studied GFR, RPP using MRI, and markers of kidney injury within 10 h after transplantation. After induction of BD, kidneys were removed from ∼63-kg donors and kept in cold storage for ∼22 h until transplanted into small (∼15 kg, n = 8) or size-matched (n = 8) recipients. A reduction in GFR was observed in small recipients within 60 min after reperfusion. Interestingly, this was associated with a significant reduction in medullary RPP, while there was no significant change in the size-matched recipients. No difference was observed in urinary NGAL excretion between the groups. A significant higher level of HO-1 mRNA was observed in small recipients than in donors and size-matched recipients indicating cortical injury. Improvement in early graft perfusion may be a goal to improve short- and long-term GFR and avoid graft thrombosis in pediatric recipients.
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Affiliation(s)
- Kristian Ravlo
- Department of Nephrology Anaesthesiology, Aarhus University Hospital Institute of Clinical Medicine, The Netherlands
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Ravlo K, Koefoed-Nielsen P, Secher N, Søndergaard P, Keller A, Petersen M, Møldrup U, Østraat E, Bibby B, Jørgensen T, Tønnesen E, Jespersen B. Effect of remote ischemic conditioning on dendritic cell number in blood after renal transplantation — flow cytometry in a porcine model. Transpl Immunol 2012; 26:146-50. [DOI: 10.1016/j.trim.2011.10.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2011] [Revised: 10/17/2011] [Accepted: 10/25/2011] [Indexed: 11/25/2022]
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13
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Jønler M, Møldrup U. [Picture of the month: bladder calculi]. Ugeskr Laeger 2005; 167:3603. [PMID: 16219193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
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Ravn HB, Møldrup U, Ilkjaer LB, Chew M, Jensen L, Johnsen S, Birk-Sørensen L, Tønnesen E, Hjortdal VE. A new model for evaluation of thrombosis and ischaemia/reperfusion injury. APMIS 2000; 108:373-9. [PMID: 10937776 DOI: 10.1034/j.1600-0463.2000.d01-71.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND The purpose of the present study was to describe infarct size and platelet accumulation when reperfusion injury was combined with a thrombogenic lesion in the coronary artery. The left anterior descending artery was damaged in 11 pigs and subsequently occluded proximal to the lesion for 50 min, followed by 4 h of reperfusion. RESULTS The infarct size/area at risk was 40 (35 63)%. Infarct size correlated with troponin-T-3 h (p=0.85, p<0.002), but not with creatine kinase-3 h. Platelet aggregation decreased by 34% (p<0.01) at 15 min of reperfusion, but returned to baseline. Platelet accumulation in the left ventricle was significantly higher in the area at risk (194 (157-206)%) compared to the right ventricle (137 (120-142)%); p<0.05). CONCLUSION A decreased platelet reactivity and increased accumulation of platelets in the area at risk indicates that activated platelets become entrapped in the myocardium. Troponin-T was a better marker of myocardial damage than creatine kinase in this in vivo model with pigs.
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Affiliation(s)
- H B Ravn
- Institute of Experimental & Clinical Research, Aarhus University Hospital, Denmark
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