Reduced P-selectin expression on circulating platelets after prolonged cold preservation in renal transplantation.
The uremic state in patients with terminal renal insufficiency is accompanied by a bleeding tendency connected with platelet dysfunction. Prolonged cold ischemia and inflammatory interactions between leukocytes, platelets and endothelial cells contribute to ischemia-/reperfusion (I/R) injury and may impair long-term graft survival. We evaluated the influence of the duration of cold preservation time on the expression of platelet GPIIb/IIIa and P-selectin and on the formation of leukocyte-platelet complexes after kidney transplantation. Fourteen patients undergoing kidney transplantation were divided into group I with long preservation time (26.6 +/- 1.9 h) and group II with short preservation time (8 +/- 6.1 h). Five venous blood samples (3 ml) were taken before induction of anesthesia, 12 h, 2, 7 and 14 d after transplantation. Surface expression of the GPIIb/IIIa, P-selectin and the percentage of platelet-granulocyte complexes were quantified by flow cytometry. Additionally blood from seven healthy volunteers was analyzed. GPIIb/IIIa and P-selectin expression on circulating platelets were significantly decreased in the long and the short-term graft preservation group compared with healthy volunteers. A significantly reduced P-selectin expression was found in the long-term preservation group compared with the short-term group. The percentage of platelet-granulocyte complexes also decreased in both preservation groups in the first 2 d after reperfusion and remained in this state in the long-term preservation group. Reduced expression of P-selectin on circulating platelets may be an indicator of I/R injury after prolonged kidney graft preservation.
Scheinichen
Dirk
D
Department of Anaesthesiology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany. scheinichen.dirk@mh-hannover.de
zu Vilsendorf
Andreas Meyer
AM
Weissig
Annette
A
Bornscheuer
Albrecht
A
Becker
Thomas
T
Juettner
Bjoern
B
Mahr
Karl-Heinz
KH
Heine
Joern
J
D001792:Blood Platelets / Q000378:metabolism* / Q000502:physiology; D003080:Cold Temperature; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000601:surgery; D016030:Kidney Transplantation; D017493:Leukocyte Common Antigens / Q000032:analysis; D007962:Leukocytes / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009926:Organ Preservation; D019007:P-Selectin / Q000097:blood*; D010446:Peptide Fragments / Q000494:pharmacology; D015539:Platelet Activation; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000378:metabolism; D040201:Platelet Membrane Glycoprotein IIb / Q000032:analysis; D013997:Time Factors
D019007:P-Selectin; D010446:Peptide Fragments; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D040201:Platelet Membrane Glycoprotein IIb; C082835:thrombin receptor peptide (42-47); D017493:Leukocyte Common Antigens