title: Improved GFR and renal plasma perfusion following remote ischaemic conditioning in a porcine kidney transplantation model.
abstract: Delayed graft function (DGF) complicates approximately 25% of kidney allografts donated after brain death (DBD). Remote ischaemic conditioning (rIC) involves brief, repetitive, ischaemia in a distant tissue in connection with ischaemia/reperfusion in the target organ. rIC has been shown to induce systemic protection against ischaemic injuries. Using a porcine kidney transplantation model with donor (63 kg) recipient (15 kg) size mismatch, we investigated the effects of recipient rIC on early renal plasma perfusion and GFR. Brain death was induced in donor pigs (n = 8) and kidneys were removed and kept in cold storage until transplantation. Nephrectomized recipient pigs were randomized to rIC (n = 8) or non-rIC (n = 8) with one kidney from the same donor in each group. rIC consisted of 4 × 5 min clamping of the abdominal aorta. GFR was significantly higher in the rIC group compared with non-rIC (7.2 ml/min vs. 3.4 ml/min; ΔGFR = 3.7 ml/min, 95%-CI: 0.3-7.2 ml/min, P = 0.038). Renal plasma perfusion in both cortex and medulla measured by dynamic contrast-enhanced magnetic resonance imaging (MRI) was significantly higher over time in the rIC group compared with non-rIC. This experimental study demonstrated a positive effect of rIC on early graft perfusion and function in a large animal transplantation model.
authors: Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark.
authors: Peter
authors: P
authors: Soendergaard
authors: Nicoline V
authors: NV
authors: Krogstrup
authors: Niels G
authors: NG
authors: Secher
authors: Kristian
authors: K
authors: Ravlo
authors: Anna K
authors: AK
authors: Keller
authors: Else
authors: E
authors: Toennesen
authors: Bo M
authors: BM
authors: Bibby
authors: Ulla
authors: U
authors: Moldrup
authors: Ernst O
authors: EO
authors: Ostraat
authors: Michael
authors: M
authors: Pedersen
authors: Troels M
authors: TM
authors: Jorgensen
authors: Henri
authors: H
authors: Leuvenink
authors: Rikke
authors: R
authors: Norregaard
authors: Henrik
authors: H
authors: Birn
authors: Niels
authors: N
authors: Marcussen
authors: Bente
authors: B
authors: Jespersen
mesh_terms: D000818:Animals; D015415:Biomarkers; D001794:Blood Pressure; D005260:Female; D005919:Glomerular Filtration Rate; D051547:Heme Oxygenase-1 / Q000378:metabolism; D007511:Ischemia / Q000473:pathology*; D007668:Kidney / Q000473:pathology*; D007674:Kidney Diseases / Q000628:therapy*; D016030:Kidney Transplantation / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods; D009392:Nephrectomy / Q000379:methods; D010477:Perfusion; D013552:Swine; D019172:Transplantation Conditioning
chemical_list: D015415:Biomarkers; D051547:Heme Oxygenase-1