title: Early outcome in renal transplantation from large donors to small and size-matched recipients - a porcine experimental model.
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.
authors.affiliation: Department of Nephrology Anaesthesiology, Aarhus University Hospital Institute of Clinical Medicine, The Netherlands.
authors.forename: Kristian
authors.initials: K
authors.lastname: Ravlo
authors.forename: Tashi
authors.initials: T
authors.lastname: Chhoden
authors.forename: Peter
authors.initials: P
authors.lastname: Søndergaard
authors.forename: Niels
authors.initials: N
authors.lastname: Secher
authors.forename: Anna K
authors.initials: AK
authors.lastname: Keller
authors.forename: Michael
authors.initials: M
authors.lastname: Pedersen
authors.forename: Bo M
authors.initials: BM
authors.lastname: Bibby
authors.forename: Troels Munch
authors.initials: TM
authors.lastname: Jørgensen
authors.forename: Ulla
authors.initials: U
authors.lastname: Møldrup
authors.forename: Ernst Øivind
authors.initials: EØ
authors.lastname: Ostraat
authors.forename: Henrik
authors.initials: H
authors.lastname: Birn
authors.forename: Rikke
authors.initials: R
authors.lastname: Nørregaard
authors.forename: Niels
authors.initials: N
authors.lastname: Marcussen
authors.forename: Henri G
authors.initials: HG
authors.lastname: Leuvenink
authors.forename: Bente
authors.initials: B
authors.lastname: Jespersen
mesh_terms: D000209:Acute-Phase Proteins / Q000096:biosynthesis; D000818:Animals; D015415:Biomarkers / Q000652:urine; D049628:Body Size; D005260:Female; D005919:Glomerular Filtration Rate; D006085:Graft Survival; D051547:Heme Oxygenase-1 / Q000096:biosynthesis; D016030:Kidney Transplantation / Q000379:methods*; D000071068:Lipocalin-2; D054834:Lipocalins / Q000096:biosynthesis; D008279:Magnetic Resonance Imaging / Q000379:methods; D023421:Models, Animal; D009929:Organ Size; D010477:Perfusion; D011518:Proto-Oncogene Proteins / Q000096:biosynthesis; D015427:Reperfusion Injury; D012306:Risk; D013552:Swine; D013927:Thrombosis; D013997:Time Factors
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C097278:Lcn2 protein, rat; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D051547:Heme Oxygenase-1