Cadaveric renal allograft at the time of implantation has the similar immunological features with the rejecting allograft.
BACKGROUND
Compared to living donations, cadaveric transplants have a poorer outcome, and the immunologic status of renal tissues at the time of transplantation might influence the final outcome of the renal allograft.


METHODS
We used quantitative RT-PCR to evaluate the differential expression of cytokine genes from 37 implantation tissues [18 cadaveric tissues (CI), 19 specimens from living donors (LI)]. We compared them with 17 acutely rejecting allograft (AR).


RESULTS
Acute rejection within 6 months after transplantation occurred 8 times in patients with cadaveric allograft, but the living-donor recipients experienced 4 episodes (P<0.05). Proinflammatory cytokines were co-expressed more frequently in CI than in LI. The levels of IFN-gamma, TNF-alpha and IL-10 mRNA were also higher in CI. We compared the profiles of several cytokine expressions of CI with those of AR. The messages for IL-6 were more abundant in the CI, IFN-gamma was more expressed in AR, and the other cytokine expression levels were similar in both types. However, when comparing LI and AR, all the cytokine messages except IL-6 were up-regulated in AR than in LI. In CI, the levels of cytokine gene expressions were similar despite various cold ischemic time except IL-10 that were elevated for those cases where the operation was done within 4 hr of nephrectomy.


CONCLUSIONS
The numbers and levels of gene transcription of inflammatory cytokines were higher in the tissues from a cadaver, and were not different from those of AR. This immunologic hostility at the time of implantation would contribute to the poorer outcome of cadaveric allograft.
Kim
Y S
YS
Department of Internal Medicine and Clinical Research Institute, Seoul National University College of Medicine, Korea.
Lim
C S
CS
Kim
S
S
Lee
J S
JS
Lee
S
S
Kim
S T
ST
Kim
H J
HJ
Chae
D W
DW
D001706:Biopsy; D002102:Cadaver; D016207:Cytokines / Q000235:genetics; D006084:Graft Rejection / Q000276:immunology / Q000473:pathology; D006801:Humans; D007371:Interferon-gamma / Q000235:genetics; D016753:Interleukin-10 / Q000235:genetics; D016030:Kidney Transplantation / Q000276:immunology*; D019520:Living Donors; D013997:Time Factors; D009927:Tissue and Organ Procurement / Q000592:standards; D014158:Transcription, Genetic; D016896:Treatment Outcome
D016207:Cytokines; D016753:Interleukin-10; D007371:Interferon-gamma