The contribution of adhesion molecule expression in donor kidney biopsies to early allograft dysfunction.
BACKGROUND
Renal allograft rejection is associated with the expression of adhesion molecules on vascular endothelial and tubular epithelial cells.


METHODS
To assess whether the number of cell adhesion molecules expressed in donor kidneys can predict early rejection or delayed graft function, kidney biopsies from 20 living and 53 cadaveric kidney donors were obtained before engraftment into the recipients and the expression of the cell adhesion molecules intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1), and endothelial leukocyte adhesion molecule (E-selectin) were determined by immunohistochemistry.


RESULTS
All biopsies from living donors showed significantly lower expression of ICAM-1 and VCAM-1 compared to biopsies from cadaveric donors. There was no difference in the expression of adhesion molecules on tubular cells between transplants with primary function compared to allografts with early rejection in living donated kidneys (ICAM-1: 2+/-8 vs. 3+/-8%; VCAM-1: 9+/-7 vs. 1+/-1%), as well as in cadaveric kidneys (ICAM-1: 38+/-29 vs. 39+/-38%; VCAM-1: 55+/-27 vs. 48+/-29%). The expression of ICAM-1 molecules on tubular cells was determined to be a predictor for the occurrence of delayed graft function in cadaveric kidneys (ICAM-1: 65+/-24* vs. 38+/-29% delayed graft versus primary graft function). No delayed graft function occurred in recipients of living donated kidneys.


CONCLUSIONS
These data suggest that adhesion molecule expression in donor biopsies is not a predictor for early allograft rejection, but can be used as a marker for the development of postischemic acute renal allograft failure.
Schwarz
C
C
Klinik für Innere Medizin III, Abteilung für Nephrologie und Dialyse, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
Regele
H
H
Steininger
R
R
Hansmann
C
C
Mayer
G
G
Oberbauer
R
R
D000328:Adult; D001706:Biopsy; D019040:E-Selectin / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism*; D007668:Kidney / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D011184:Postoperative Period; D011379:Prognosis; D051437:Renal Insufficiency / Q000209:etiology / Q000503:physiopathology; D014019:Tissue Donors; D019010:Vascular Cell Adhesion Molecule-1 / Q000378:metabolism*
D019040:E-Selectin; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1