Early outcome in renal transplantation from large donors to small and size-matched recipients - a porcine experimental model

Pediatr Transplant. 2012 Sep;16(6):599-606. doi: 10.1111/j.1399-3046.2012.01707.x. Epub 2012 May 14.

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.

MeSH terms

  • Acute-Phase Proteins / biosynthesis
  • Animals
  • Biomarkers / urine
  • Body Size
  • Female
  • Glomerular Filtration Rate
  • Graft Survival
  • Heme Oxygenase-1 / biosynthesis
  • Kidney Transplantation / methods*
  • Lipocalin-2
  • Lipocalins / biosynthesis
  • Magnetic Resonance Imaging / methods
  • Models, Animal
  • Organ Size
  • Perfusion
  • Proto-Oncogene Proteins / biosynthesis
  • Reperfusion Injury
  • Risk
  • Swine
  • Thrombosis
  • Time Factors

Substances

  • Acute-Phase Proteins
  • Biomarkers
  • Lcn2 protein, rat
  • Lipocalin-2
  • Lipocalins
  • Proto-Oncogene Proteins
  • Heme Oxygenase-1