[Effect of ulinastatin in promotion of graft recovery in early stage after kidney transplantation: a clinical study].
OBJECTIVE
To investigate the effects of ulinastatin (UTI), a urinary trypsin inhibitor, on the promotion of the function recovery of transplanted kidney, especially for those with acute tubular necrosis (ATN).


METHODS
Thirty patients underwent general cadaver kidney transplantation were randomly allocated to 2 equal groups: Group A (UTI-treatment group) and Group B (control group). 40 patients whose allografts were presumed to be with acute tubular necrosis (ATN) were also divided into 2 equal groups: Group C (UTI-treatment group) and Group D (control group). Group A and C were given ulinastatin perioperatively. 1, 3, 7, and 10 days after the transplantation blood and urine samples were collected. The levels of urine and blood alpha1-microglobulin (MG) were detected by radioimmunoassay. Blood IL-8, IL-10, and serum creatine (sCr) were detected by ELISA.


RESULTS
Within 10 days after the transplantation the urine volume of Group A significantly increased, especially the urine volumes of days 2, 6, 7, 9, and 10 were significant greater than those of Group B (all P < 0.05). The levels of blood IL-8 of Group A in days 1 and 3 were (93.75 +/- 31.5) ng/L and (41.98 +/- 24.01) ng/L respectively, significantly lower than those of Group B [(135.0 +/- 31.2) ng/L and (78.34 +/- 76.39) ng/L respectively, both P < 0.05]. The levels of urine alpha1-MG in days 1 and 3 were (69.89 +/- 32.60) mg/L and (35.33 +/- 34.54) mg/L respectively, both significantly lower than those of Group B [(91.15 +/- 28.39) mg/L and (65.84 +/- 33.38) mg/L respectively, both P < 0.05]. In group C, the levels of blood alpha1-MG in days 7 and 10 of Group C were (118.26 +/- 41.23) mg/L and (99.49 +/- 68.63) mg/L respectively, both significantly lower than those of Group D [(187.15 +/- 55.23) mg/L and (151.27 +/- 87.42) mg/L respectively, both P < 0.05]. The urine alpha1-MG in days 7 and 10 were (39.89 +/- 22.32) mg/L and (38.21 +/- 20.36) mg/L respectively, both significantly lower than those of Group D [(67.34 +/- 21.56) mg/L and (62.26 +/- 29.24) mg/L respectively, both P < 0.05]. Compared to Group D, the increasing tendency of blood IL-8 was better suppressed in Group C, and the diuretic phases appeared earlier.


CONCLUSIONS
UTI significantly improves the microcirculation, protects the tubule of transplanted kidney, increases the volume of urine, inhibits the inflammatory response, and promotes the recovery of ATN during the perioperative period of kidney transplantation.
Qiu
Jiang
J
Department of Organ Transplantation, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
Wang
Chang-Xi
CX
Chen
Li-Zhong
LZ
Fei
Ji-Guang
JG
Bi
Jiong
J
D000510:Alpha-Globulins / Q000378:metabolism; D003401:Creatine / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D006023:Glycoproteins / Q000627:therapeutic use*; D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D016030:Kidney Transplantation / Q000379:methods*; D011184:Postoperative Period; D020127:Recovery of Function / Q000187:drug effects*; D016896:Treatment Outcome; D014361:Trypsin Inhibitors / Q000627:therapeutic use
D000510:Alpha-Globulins; D006023:Glycoproteins; D016209:Interleukin-8; D014361:Trypsin Inhibitors; C016001:alpha-1-microglobulin; D016753:Interleukin-10; D003401:Creatine; C028665:urinastatin